Organization
CHRISTENBURY EYE CENTER P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN D CHRISTENBURY M.D. (OWNER)
(704) 332-9365
Entity
Organization
Contact information
Practice address
3621 RANDOLPH RD, SUITE 100, CHARLOTTE, NC 28211-1317
(704) 332-9365
(704) 364-7384
Mailing address
3621 RANDOLPH RD, SUITE 100, CHARLOTTE, NC 28211-1317
(704) 332-9365
(704) 364-7384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
57056
NC
207W00000X
Ophthalmology Physician
Primary
57056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0286V
BCBS/NC
NC
01
—
7085246
AETNA
NC
05
—
890286V
—
NC
Enumeration date
04/20/2006
Last updated
10/03/2007
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