# SOUTHERN EYE ASSOCIATES, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518162445
- **Authorized official:** PHILIP L MARTIN M.D. (PRESIDENT)
- **Authorized official phone:** (919) 571-0081

## Contact information

- **Practice address:** 2801 BLUE RIDGE RD STE 200, RALEIGH, NC 27607-6474
- **Practice address phone:** (919) 571-0081
- **Mailing address:** 2801 BLUE RIDGE RD STE 200, RALEIGH, NC 27607-6474
- **Mailing address phone:** (919) 571-0081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | AS0048 | NC | Yes |

## Other

- **Enumeration date:** 06/20/2007
- **Last updated:** 06/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00652 | BCBS ASC | NC |
| 05 | — | 3409867 | — | NC |
| 01 | — | 490001936 | RAILROAD MED ASC | NC |