Organization
JACKSON EYE ASSOCIATES, OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERI BETH CLABBY (OFFICE MANAGER)
(910) 793-1157
Entity
Organization
Contact information
Practice address
1611 GREENFIELD ST, WILMINGTON, NC 28401-6455
(910) 264-3625
(910) 392-5899
Mailing address
5135 CAROLINA BEACH RD, WILMINGTON, NC 28412-2516
(910) 793-1157
(910) 793-1158
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1907
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5908347
—
NC
Enumeration date
01/24/2011
Last updated
01/24/2011
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