Triad Eye Associates Od Pa | |
10564 N Main St, Suite E, Archdale, NC 27263-2808 | |
(336) 434-4033 | |
(336) 434-6680 |
Full Name | Triad Eye Associates Od Pa |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 10564 N Main St, Archdale, 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 |
---|---|---|---|
1649228669 | NPI | - | NPPES |
790274P | Medicaid | NC | |
0274P | Other | NC | BCBS/NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Charles R Gilliam |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720083199 PECOS PAC ID: 8325000417 Enrollment ID: I20041222000727 |
Provider Name | Cathy A Fulp |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1902803323 PECOS PAC ID: 2769440502 Enrollment ID: I20041228000267 |
Provider Name | Stacey S Hutto |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1447234711 PECOS PAC ID: 4486667870 Enrollment ID: I20060802000150 |
Provider Name | William N Hutto |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1821191669 PECOS PAC ID: 4082716709 Enrollment ID: I20070227000733 |
Provider Name | Kimberly G Orr |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1043611734 PECOS PAC ID: 5395069272 Enrollment ID: I20150123002262 |
Mailing Address | Practice Location Address |
---|---|
Triad Eye Associates Od Pa Po Box 4370, Archdale, NC 27263-4370 Ph: (336) 434-4033 | Triad Eye Associates Od Pa 10564 N Main St, Suite E, Archdale, NC 27263-2808 Ph: (336) 434-4033 |
Mitchell N Evans, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 10564 N Main St Ste E, Archdale, NC 27263 Phone: 336-434-4033 Fax: 336-434-4035 | |
Charles Rick Gilliam, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 311 Trindale Rd, Ste D, Archdale, NC 27263 Phone: 336-434-4033 Fax: 336-434-4035 | |
Cathy A Fulp, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 10564 N Main St, Ste E, Archdale, NC 27263 Phone: 336-434-4033 Fax: 336-434-4035 |