Organization
GASTON EYE ASSOCIATES
Active
Organization
GASTON EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOB MCCULLEN JR. M.D. (MANAGING PARTNER)
(704) 853-3937
Entity
Organization
Contact information
Practice address
2325 ABERDEEN BLVD, STE A, GASTONIA, NC 28054-0614
(704) 853-3937
(704) 853-0840
Mailing address
2325 ABERDEEN BLVD, STE A, GASTONIA, NC 28054-0614
(704) 853-3937
(704) 853-0840
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0185B
BLUE CROSS OF NC
NC
01
—
50344
MEDCOST
NC
05
—
890185B
—
NC
01
—
NONE
PARTNERS
NC
Enumeration date
10/11/2005
Last updated
08/04/2008
Update your record
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