Organization
BRAD HEARN OD PA
Active
Other names
LakesideEye Associates, Lakeside Eye Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL BRADFORD HEARN O.D. (OWNER)
(704) 896-3311
Entity
Organization
Contact information
Practice address
16525 BIRKDALE CMNS PKWY, SUITE 100, HUNTERSVILLE, NC 28078-3802
(704) 896-3311
(704) 896-5514
Mailing address
16525 BIRKDALE CMNS PKWY, SUITE 100, HUNTERSVILLE, NC 28078-3802
(704) 896-3311
(704) 896-5514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1223
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0916H
BCBSNC
NC
05
—
8909402
—
NC
Enumeration date
04/23/2008
Last updated
07/21/2022
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