Individual
DR. AGEN J HERRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1525 BENVENUE RD, ROCKY MOUNT, NC 27804-6383
(252) 557-2257
(252) 972-0003
Mailing address
1525 BENVENUE RD, ROCKY MOUNT, NC 27804-6383
(252) 557-2257
(252) 972-0003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2335
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12587847
CAQH
NC
01
—
2335
LICENSE
NC
01
—
47-1497698
TAX ID
NC
Enumeration date
09/29/2013
Last updated
08/29/2014
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