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Individual

DAVID ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2807 N MAIN ST, TARBORO, NC 27886-1903
(252) 823-8295
Mailing address
2807 N MAIN ST, TARBORO, NC 27886-1903
(252) 823-8295

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1077
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09025
BCBS
NC
01
2251777
UNITED HEALTHCARE
NC
01
410022128
RAILROAD MEDICARE
NC
01
66234
MEDCOST
NC
05
8909025
NC
Enumeration date
01/23/2006
Last updated
08/07/2012
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