Organization
ASHEBORO OPTOMETRIC VISION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK W ROBERTS V O.D. (PRESIDENT)
(336) 625-2429
Entity
Organization
Contact information
Practice address
177 NC HIGHWAY 42 N STE B, ASHEBORO, NC 27203-7955
(336) 625-2429
(336) 625-9901
Mailing address
177 NC HIGHWAY 42 N STE B, ASHEBORO, NC 27203-7955
(336) 625-2429
(336) 625-9901
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1200
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09778
BCBS
NC
01
—
1962684605
INDIVIDUAL MEDICARE NPI
NC
05
—
8909778
—
NC
Enumeration date
03/09/2007
Last updated
09/18/2008
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