Organization
COASTAL VISION CENTER OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RANDALL KIRBY OD (OWNER)
(910) 641-0011
Entity
Organization
Contact information
Practice address
2183 JAMES B WHITE HWY N, WHITEVILLE, NC 28472-8989
(910) 641-0011
(910) 641-0083
Mailing address
2183 JAMES B WHITE HWY N, WHITEVILLE, NC 28472-8989
(910) 641-0011
(910) 641-0083
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1548
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890913P
—
NC
Enumeration date
01/17/2007
Last updated
12/23/2024
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