Organization
GREENSBORO OPHTHALMOLOGY ASSOC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA JACKSON RN, MSN (PRACTICE ADMINISTRATOR)
(336) 274-4626
Entity
Organization
Contact information
Practice address
8 N POINTE CT, GREENSBORO, NC 27408-3187
(336) 274-4626
(336) 274-7952
Mailing address
8 N POINTE CT, GREENSBORO, NC 27408-3187
(336) 274-4626
(336) 274-7952
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD4787
RR MEDICARE
NC
Enumeration date
10/03/2006
Last updated
09/16/2024
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