Individual
KENT JAMES RISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
216 NORTHSTONE PL, FAYETTEVILLE, NC 28303-5494
(910) 527-9517
Mailing address
216 NORTHSTONE PL, FAYETTEVILLE, NC 28303-5494
(910) 527-9517
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1555
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0900E
BLUE CROSS BLUE SHIELD
NC
01
—
2238851
UNITED HEALTHCARE
NC
05
—
890900E
—
NC
Enumeration date
01/26/2006
Last updated
08/06/2010
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