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Individual

DR. MARK W GIFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3219 PINEVILLE MATTHEWS RD, CHARLOTTE, NC 28226-9301
(704) 541-0468
(704) 542-0318
Mailing address
3219 PINEVILLE MATTHEWS RD, CHARLOTTE, NC 28226-9301
(704) 541-0468
(704) 542-0318

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1515
SC
152W00000X
Optometrist
2006017274
MO
152W00000X
Optometrist
Primary
2112
NC

Other

Enumeration date
07/08/2006
Last updated
02/15/2009
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