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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
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