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Organization

UNIVERSITY EYE ASSOCIATES, OD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KELLY ALEXANDER (ADMINISTRATOR)
(704) 547-1551
Entity
Organization

Contact information

Practice address
9651 BROOKDALE DR., SUITE 800, CHARLOTTE, NC 28215-8105
(704) 536-6042
(704) 563-5917
Mailing address
9651 BROOKDALE DR., SUITE 800, CHARLOTTE, NC 28215-8105
(704) 536-6042
(704) 563-5917

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09040
BLUE CROSS BLUE SHIELD
NC
05
7909040
NC
Enumeration date
05/01/2006
Last updated
06/29/2012
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