Organization
SPECTRUM FAMILY EYE CENTER OPTOMETRIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORANCE KENNEDY BURNGARNER OD (PRESIDENT)
(910) 692-3937
Entity
Organization
Contact information
Practice address
160 FOX HOLLOW, PINEHURST, NC 28374
(910) 692-3937
(910) 692-5908
Mailing address
160 FOX HOLLOW, PINEHURST, NC 28374
(910) 692-3937
(910) 692-5908
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0224E
BCBS
—
01
—
4528892
AETNA
NC
05
—
890224E
—
NC
Enumeration date
06/27/2006
Last updated
06/21/2018
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