Organization
DOCTORS VISION CENTER OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA M BURGESS (CREDENTIALING SPECIALIST)
(252) 442-0802
Entity
Organization
Contact information
Practice address
215 MOORE RD, KING, NC 27021-8703
(336) 985-2020
(336) 985-2133
Mailing address
215 MOORE RD, KING, NC 27021-8703
(336) 985-2020
(336) 985-2133
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017J1
BCBS GRP #
NC
05
—
5900613
—
NC
Enumeration date
05/04/2006
Last updated
08/30/2011
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