Organization
DAVIS OPHTHALMOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD TYLER DAVIS DO (REGISTERED AGENT/OWNER)
(336) 838-5121
Entity
Organization
Contact information
Practice address
408 8TH ST STE 2, NORTH WILKESBORO, NC 28659-4167
(336) 838-5121
(336) 667-5756
Mailing address
408 8TH ST STE 2, NORTH WILKESBORO, NC 28659-4167
(336) 838-5121
(336) 667-5756
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
201700503
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14007221
CAQH
—
01
—
1456663889
PECOS
—
01
—
19SQD
BLUE CROSS BLUE SHIELD
NC
Enumeration date
07/11/2018
Last updated
03/07/2023
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