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
108 W MAIN ST, BISCOE, NC 27209-9526
(910) 428-4900
(910) 428-4909
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-B
NC
01
—
085351000
CIGNA GOVERNMENT SERVICES MEDICARE PART B DME
NC
05
—
89011KT
—
NC
Enumeration date
05/02/2007
Last updated
01/07/2011
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