Organization
G. M. CONEKIN, III, OD, PA
Active
Other names
Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE M. CONEKIN III OD (OWNER)
(910) 353-0541
Entity
Organization
Contact information
Practice address
200 DOCTORS DR, SUITE K, JACKSONVILLE, NC 28546-6310
(910) 353-0541
(910) 353-5353
Mailing address
200 DOCTORS DRIVE, SUITE K, JACKSONVILLE, NC 28546-6308
(910) 353-0541
(910) 353-5353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1181
NC
152W00000X
Optometrist
2082
NC
152W00000X
Optometrist
2122
NC
152WC0802X
Corneal and Contact Management Optometrist
2082
NC
152WC0802X
Corneal and Contact Management Optometrist
2122
NC
152WL0500X
Low Vision Rehabilitation Optometrist
1181
NC
152WP0200X
Pediatric Optometrist
1181
NC
152WP0200X
Pediatric Optometrist
2082
NC
152WP0200X
Pediatric Optometrist
2122
NC
152WS0006X
Sports Vision Optometrist
1181
NC
152WV0400X
Vision Therapy Optometrist
1181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09328
BCBS
NC
01
—
170000072
RAILROAD MEDICARE
NC
05
—
7909328
—
NC
01
—
Y1605
BLIND COMMISSION
NC
Enumeration date
04/12/2011
Last updated
04/12/2011
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