Organization
MOUNT HOLLY EYE CLINIC, OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA MARIE FOX-PUTNAM OD (OWNER)
(704) 822-0099
Entity
Organization
Contact information
Practice address
612 S MAIN ST, MOUNT HOLLY, NC 28120-1653
(704) 822-0099
(704) 822-0077
Mailing address
612 S MAIN ST, MOUNT HOLLY, NC 28120-1653
(704) 822-0099
(704) 822-0077
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1387
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0928G
BLUE CROSS/BLUE SHIELD
NC
01
—
12304
SPECTERA
NC
01
—
4622
DAVIS VISION
NC
05
—
890928G
—
NC
01
—
NC 1387
VISION BENEFITS OF AMERIC
NC
01
—
OP0469
EYEMED
NC
Enumeration date
12/13/2007
Last updated
01/14/2010
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