Organization
PORT CITY EYE ASSOCIATES, OD, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBIE C PREVATT (PRACTICE COORDINATOR)
(910) 947-6285
Entity
Organization
Contact information
Practice address
8262 MARKET ST, SUITE 103, WILMINGTON, NC 28411-9805
(910) 686-3396
(910) 686-3398
Mailing address
8262 MARKET ST, SUITE 103, WILMINGTON, NC 28411-9805
(910) 686-3396
(910) 686-3398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1904
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093RU
BCBS
NC
01
—
1699866145
NPI-PERSONAL
—
05
—
89093RU
—
NC
01
—
U99114
UPIN
NC
Enumeration date
08/01/2007
Last updated
03/27/2010
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