Organization
GENESIS EYE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GALEN GRAYSON MD (OWNER)
(704) 295-0001
Entity
Organization
Contact information
Practice address
817 EAST MOREHEAD STREET, SUITE 200, CHARLOTTE, NC 28202-2767
(704) 295-0001
(704) 295-0002
Mailing address
817 EAST MOREHEAD STREET, SUITE 200, CHARLOTTE, NC 28202-2767
(704) 295-0001
(704) 295-0002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891024Y
—
NC
Enumeration date
05/25/2006
Last updated
08/22/2020
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