Individual
DR. ELWOOD GLENN LIKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
4130 WESTERN BLVD, JACKSONVILLE, NC 28546-6740
(910) 353-9200
(910) 353-5459
Mailing address
15933 CLAYTON RD STE 210, BALLWIN, MO 63011-2172
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1550
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890903R
—
NC
Enumeration date
05/18/2006
Last updated
11/10/2025
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