Individual
DR. TIFFANY LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4540 MAIN ST, SHALLOTTE, NC 28459-3079
(910) 754-3358
(910) 154-9326
Mailing address
9712 STURGEON DR NE, LELAND, NC 28451-8452
(919) 606-2802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1913
NC
152WC0802X
Corneal and Contact Management Optometrist
1913
NC
152WS0006X
Sports Vision Optometrist
1913
NC
152WX0102X
Occupational Vision Optometrist
1913
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093PE
BCBS NUMBER
NC
05
—
89093PE
—
NC
Enumeration date
06/09/2006
Last updated
12/03/2009
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