Organization
SOUTHERN EYE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP L MARTIN M.D. (PRESIDENT)
(919) 571-0081
Entity
Organization
Contact information
Practice address
2801 BLUE RIDGE RD STE 200, RALEIGH, NC 27607-6474
(919) 571-0081
Mailing address
2801 BLUE RIDGE RD STE 200, RALEIGH, NC 27607-6474
(919) 571-0081
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
AS0048
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00652
BCBS ASC
NC
05
—
3409867
—
NC
01
—
490001936
RAILROAD MED ASC
NC
Enumeration date
06/20/2007
Last updated
06/22/2010
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