Organization
ACADEMY EYE CENTER OPTOMETRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANFORD RAYNOR OD (PRESIDENT)
(336) 460-0499
Entity
Organization
Contact information
Practice address
209 W NAOMI ST, RANDLEMAN, NC 27317-1733
(336) 495-5700
(336) 495-1174
Mailing address
1120 RANDOLPH ST, SUITE 32, THOMASVILLE, NC 27360-5174
(336) 475-0143
(336) 472-6831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1464
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011KT
BCBS GROUP-R
NC
01
—
0853510001
CIGNA GOVERNMENT SERVIES MEDICARE PART B DME
NC
05
—
89011KP
—
NC
Enumeration date
03/13/2007
Last updated
01/07/2011
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