Organization
LIVE OAK OPHTHALMOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN J GROAT MD (PRESIDENT)
(843) 822-5496
Entity
Organization
Contact information
Practice address
1915 S 17TH ST, SUITE 101, WILMINGTON, NC 28401-6681
(910) 251-8200
(910) 251-8204
Mailing address
1915 S 17TH ST, SUITE 101, WILMINGTON, NC 28401-6681
(910) 251-8200
(910) 251-8204
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
09/19/2013
Last updated
09/19/2013
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