Organization
HENDERSONVILLE EYE CARE, OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW R CANNON OD (OWNER)
(828) 693-5205
Entity
Organization
Contact information
Practice address
1401 HAYWOOD RD, HENDERSONVILLE, NC 28791-2335
(828) 693-5205
(828) 692-2423
Mailing address
1401 HAYWOOD RD, HENDERSONVILLE, NC 28791-2335
(828) 693-5205
(828) 692-2423
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0915P
N.C. BCBS PROV. NUMBER
NC
05
—
890915P
—
NC
Enumeration date
06/01/2006
Last updated
08/05/2014
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