Organization
WASHINGTON EYE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA JEWELL (OFFICE MANAGER)
(252) 946-2171
Entity
Organization
Contact information
Practice address
639 W 15TH ST, WASHINGTON, NC 27889-3526
(252) 946-2171
(252) 946-5986
Mailing address
639 W 15TH ST, WASHINGTON, NC 27889-3526
(252) 946-2171
(252) 946-5986
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1057
NC
207W00000X
Ophthalmology Physician
Primary
18081
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02876
BLUE CROSS BLUE SHIELD NC
NC
01
—
230152
MEDICARE PTAN
NC
05
—
8902876
—
NC
Enumeration date
07/06/2006
Last updated
12/23/2009
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