Organization
ACADEMY EYE CENTER OPTOMETRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANFORD RAYNOR OD (PRESIDENT)
(336) 460-0499
Entity
Organization
Contact information
Practice address
753 NC 24 27 BYP E, ALBEMARLE, NC 28001-5349
(704) 983-2431
(704) 982-2578
Mailing address
1120 RANDOLPH ST STE 32, THOMASVILLE, NC 27360-5759
(336) 495-3019
(336) 495-5703
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011KT
BCBS GROUP-A
NC
01
—
0853510001
CIGNA GOVERNMENT SERVICES MEDICARE PART B DME
NC
05
—
5902134
—
NC
Enumeration date
05/02/2007
Last updated
01/07/2011
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