Organization
TRIAD EYE CENTER OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY G KOOP OD (PRESIDENT)
(336) 271-2020
Entity
Organization
Contact information
Practice address
1305 LEES CHAPEL RD., SUITE 101, GREENSBORO, NC 27455-2599
(336) 271-2020
(336) 275-8200
Mailing address
1305 LEES CHAPEL RD., SUITE 101, GREENSBORO, NC 27455-2599
(336) 271-2020
(336) 275-8200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89014FR
—
NC
Enumeration date
02/08/2007
Last updated
07/21/2022
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