Organization
GASTON EYE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BOB KENNETH MCCULLEN JR. M.D. (MANAGING PARTNER)
(704) 853-3937
Entity
Organization
Contact information
Practice address
2325 ABERDEEN BLVD, STE A, GASTONIA, NC 28054-0614
(704) 853-3937
(704) 853-0840
Mailing address
2325 ABERDEEN BLVD, STE A, GASTONIA, NC 28054-0614
(704) 853-3937
(704) 853-0840
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
38135
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0846090001
PALMETTO
NC
Enumeration date
02/12/2007
Last updated
08/22/2020
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