Organization
PATTY VISION CENTER OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTA REID PATTY JR. (OPTOMETRIST)
(336) 599-0246
Entity
Organization
Contact information
Practice address
415 SEMORA RD, ROXBORO, NC 27573-5185
(336) 599-0246
(336) 597-3356
Mailing address
415 SEMORA RD, ROXBORO, NC 27573-5185
(336) 599-0246
(336) 597-3356
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014C5
BCBS PIN
NC
05
—
5915918
—
NC
Enumeration date
01/10/2007
Last updated
08/14/2014
Update your record
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