Individual
KELLY ANN DOTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
13532 STEELECROFT PKWY, CHARLOTTE, NC 28278-7545
(704) 295-3475
(704) 295-3476
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
(704) 295-3468
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2274
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174UK
BCBS
NC
01
—
2430696
WELLPATH
—
01
—
30139126
SELECT HEALTH
SC
01
—
3301576
CIGNA
—
05
—
5921664
—
NC
01
—
9059937
AETNA
—
05
—
DN2274
—
SC
01
—
P01223898
MEDICARE-RAILROAD
NC
Enumeration date
09/13/2012
Last updated
04/26/2021
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