Organization
COASTAL VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RANDY KIRBY O.D., P.A. (OWNER)
(910) 792-0600
Entity
Organization
Contact information
Practice address
33 S KERR AVE, WILMINGTON, NC 28403-1416
(910) 792-0600
(910) 799-5162
Mailing address
33 S KERR AVE, WILMINGTON, NC 28403-1416
(910) 792-0600
(910) 799-5162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1548
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890913P
—
NC
Enumeration date
01/18/2007
Last updated
02/11/2011
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