Individual
DR. WILLIAM CHARLES KISTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2601 BLUE RIDGE RD, STE 101, RALEIGH, NC 27607-6481
(919) 787-7181
Mailing address
2601 BLUE RIDGE RD, STE 101, RALEIGH, NC 27607-6481
(919) 787-7181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1249
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890926G
—
NC
Enumeration date
09/07/2005
Last updated
11/29/2009
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