| |
1110 Seven Lakes Dr, West End, NC 27376 | |
(910) 673-3937 | |
(910) 673-3266 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 1110 Seven Lakes Dr, West End, North Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376713685 | NPI | - | NPPES |
7909342 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1295 (North Carolina) | Primary |
Mailing Address | Practice Location Address |
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Po Box 839, 1110 Seven Lakes Dr, West End, NC 27376-0839 Ph: (910) 673-3937 | 1110 Seven Lakes Dr, West End, NC 27376 Ph: (910) 673-3937 |
Barry L Kavanaugh Jr., OD PA Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1110 Seven Lakes Dr, West End, NC 27376 Phone: 910-673-3937 Fax: 910-673-3266 |