Organization
CARLYLE DUKES HAYWOOD, JR.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLYLE HAYWOOD (OWNER)
(910) 417-7138
Entity
Organization
Contact information
Practice address
326 ALBEMARLE RD, TROY, NC 27371-3206
(910) 576-7371
Mailing address
326 ALBEMARLE RD, TROY, NC 27371-3206
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1566
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0925K
BCBS
NC
01
—
2471739
GROUP MEDICARE
NC
01
—
410043489
RR MEDICARE
NC
05
—
89013HK
—
NC
01
—
DG4307
RR MEDICARE
NC
Enumeration date
01/31/2007
Last updated
11/23/2016
Update your record
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