Individual
DR. YVONNE TRACY SHOOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1433 EMERYWOOD DR, CHARLOTTE, NC 28210-4590
(704) 553-2020
(704) 553-2256
Mailing address
1433 EMERYWOOD DR, CHARLOTTE, NC 28210-4590
(704) 553-2020
(704) 553-2256
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC1355
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0987A
BLUE CROSS BLUE SHIELD
NC
01
—
204193382
VISION SERVICE PLAN
NC
01
—
28919
PARTNERS
NC
01
—
6817040
CIGNA
NC
05
—
890987A
—
NC
Enumeration date
08/20/2006
Last updated
01/04/2023
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