Organization
SUSAN B. WISE, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN WISE O.D. (OWNER)
(828) 689-4206
Entity
Organization
Contact information
Practice address
63 CHESTNUT ST, MARS HILL, NC 28754-7542
(828) 689-4206
(828) 689-5007
Mailing address
PO BOX 850, MARS HILL, NC 28754-0850
(828) 689-4206
(828) 689-5007
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0261N
BCBSNC
NC
01
—
1053337121
GROUP NPI
NC
05
—
5900858
—
NC
01
—
DE9589
RAILROAD MEDICARE
NC
Enumeration date
07/14/2006
Last updated
04/09/2009
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