Individual
TIMOTHY JAMES HENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1071
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09387
BLUE CROSS BLUE SHIELD
NC
01
—
10799
OPTICARE
NC
01
—
110899
EYEMED
NC
01
—
2200141
UNITED HEALTHCARE
NC
01
—
48550
SPECTERA
NC
01
—
51812
DAVIS VISION PLAN
NC
01
—
561430045
SUPERIOR VISION PLAN
NC
05
—
8909387
—
NC
01
—
NC01071
VISION BENEFITS OF AMERIC
NC
Enumeration date
05/03/2006
Last updated
02/27/2013
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