Organization
PRICE EYE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE KENT PRICE MD (PHYSICIAN OWNER)
(910) 353-1030
Entity
Organization
Contact information
Practice address
264 MEMORIAL DRIVE, JACKSONVILLE, NC 28546
(910) 353-1030
(910) 353-8597
Mailing address
264 MEMORIAL DR, JACKSONVILLE, NC 28546-6332
(910) 353-1030
(910) 353-8597
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0246L
BCBS
NC
05
—
890246L
—
NC
01
—
CK8442
RAILROAD MEDICARE
—
Enumeration date
06/17/2006
Last updated
05/16/2008
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