Organization
BLUE RIDGE LASER EYE ASSOCIATES, P.A.
Active
Organization
BLUE RIDGE LASER EYE ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GENEVA F NELON (BILLING ADMINISTRATOR)
(828) 894-3037
Entity
Organization
Contact information
Practice address
192 HOSPITAL DR, COLUMBUS, NC 28722-6418
(828) 894-3037
(828) 894-7041
Mailing address
192 HOSPITAL DR, COLUMBUS, NC 28722-6418
(828) 894-3037
(828) 894-7041
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012RE
BC/BS OF NORTH CAROLINA
NC
01
—
2333605
MEDICARE GROUP
NC
01
—
8597
MEDICARE GROUP
SC
01
—
DF8060
RAILROAD MEDICARE
—
Enumeration date
05/20/2006
Last updated
11/09/2007
Update your record
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