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Individual

JASON PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
110 CAPCOM AVE STE 100, WAKE FOREST, NC 27587-6531
(919) 556-1909
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1936
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093P9
BLUE CROSS BS
NC
05
89093P9
NC
01
P00791294
RAILROAD MEDICARE
NC
Enumeration date
08/31/2005
Last updated
02/25/2022
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