Midtown Optometry Pllc | |
4109 Wake Forest Rd Ste 10, Raleigh, NC 27609-2510 | |
(984) 213-8863 | |
Not Available |
Full Name | Midtown Optometry Pllc |
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Type | Facility |
Speciality | Optometrist |
Location | 4109 Wake Forest Rd Ste 10, Raleigh, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023754298 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Keel M Godwin |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1861441834 PECOS PAC ID: 1052451283 Enrollment ID: I20091221000219 |
Mailing Address | Practice Location Address |
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Midtown Optometry Pllc 4109 Wake Forest Rd Ste 10, Raleigh, NC 27609-2510 Ph: (984) 213-8863 | Midtown Optometry Pllc 4109 Wake Forest Rd Ste 10, Raleigh, NC 27609-2510 Ph: (984) 213-8863 |
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