Organization
EYE SURGERY AND LASER CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID K. HARPER M. D. (PRESIDENT)
(704) 782-1127
Entity
Organization
Contact information
Practice address
500 LAKE CONCORD RD, CONCORD, NC 28025-2926
(704) 782-1127
(704) 782-1207
Mailing address
500 LAKE CONCORD RD NE, CONCORD, NC 28025-2926
(704) 782-1127
(704) 782-1207
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
87485
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00618
BLUE CROSS BLUE SHIELD
NC
05
—
3409839
—
NC
01
—
805608
PARTNERS MEDICARE
NC
Enumeration date
04/17/2006
Last updated
06/09/2008
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