Organization
CONRAD FAULKNER OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES C FAULKNER (OPTOMETRIST)
(252) 566-4583
Entity
Organization
Contact information
Practice address
834 HARDEE RD, VERNON PARK MALL, KINSTON, NC 28504-3360
(252) 559-2020
Mailing address
7395 US HIGHWAY 70 W, LA GRANGE, NC 28551-8211
(252) 566-4583
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0758
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09271
BCBS
NC
01
—
246158
MEDICARE ID- TYPE UNSPECIFIED
—
Enumeration date
07/29/2009
Last updated
07/29/2009
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