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Individual

ANGELA EVERETT MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
315A WESTERN BOULEVARD, JACKSONVILLE, NC 28546-6338
(910) 353-1011
(910) 353-4433
Mailing address
315A WESTERN BLVD, JACKSONVILLE, NC 28546-6338
(910) 353-1011
(910) 353-4433

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2031
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093WA
BCBSNC
NC
05
5905963
NC
Enumeration date
09/12/2006
Last updated
02/24/2022
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