Organization
JACKSONVILLE VISION CENTER, O.D.,PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY A TAYLOR (INSURANCE SPECIALIST)
(910) 326-0113
Entity
Organization
Contact information
Practice address
409 WESTERN BLVD, SUITE 700, JACKSONVILLE, NC 28546-6528
(910) 219-3937
Mailing address
409 WESTERN BLVD, SUITE 700, JACKSONVILLE, NC 28546-6528
(910) 219-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1970
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89093R2
—
NC
Enumeration date
12/27/2010
Last updated
02/02/2011
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