Individual
MR. TROY NATHANIEL TEVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD., PHD
Contact information
Practice address
337 N MAIN ST, RUTHERFORDTON, NC 28139-2505
(828) 288-8662
(828) 288-4882
Mailing address
337 N MAIN ST, RUTHERFORDTON, NC 28139-2505
(828) 288-8662
(828) 288-4882
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1807
NC
152WC0802X
Corneal and Contact Management Optometrist
1807
NC
152WP0200X
Pediatric Optometrist
1807
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0313616
CIGNA
NC
01
—
093AF
BLUECROSS BLUESHIELD
NC
01
—
24491
OPTICARE
NC
01
—
71877
MEDCOST
NC
05
—
89093AF
—
NC
01
—
NC1807
STATE LIC
NC
Enumeration date
02/26/2007
Last updated
04/16/2008
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