Organization
PIEDMONT EYE CARE O.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SCOTT O.D. (PRESIDENT)
(704) 867-1210
Entity
Organization
Contact information
Practice address
1302 E GARRISON BLVD, GASTONIA, NC 28054-5129
(704) 867-1210
Mailing address
1302 E GARRISON BLVD, GASTONIA, NC 28054-5129
(704) 867-1210
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1142
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1179
MEDICARE GROUP/ORGANIZATION PTAN
NC
05
—
5908187
—
NC
Enumeration date
01/21/2006
Last updated
08/28/2008
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