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PROVIDENCE EYE AND LASER SPECIALISTS PC NPI 1154367217


NPI Information

NPI: 1154367217
Provider Name: PROVIDENCE EYE AND LASER SPECIALISTS, PC
Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 34D2159224

Address:
3025 SPRINGBANK LN
SUITE 200
CHARLOTTE, NC
ZIP 28226
Phone: (704) 540-9595
Get Directions

PROVIDENCE EYE AND LASER SPECIALISTS, PC is an optometrist in Charlotte, NC. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. PROVIDENCE EYE AND LASER SPECIALISTS, PC NPI is 1154367217. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3025 SPRINGBANK LN
SUITE 200
CHARLOTTE, NC
ZIP 28226-362
Phone: (704) 540-9595
Fax: (704) 540-9616

The provider's authorized official is Rey Wilson .
The authorized official title is Office Manager and has the following contact phone number (704) 540-9595.

The CLIA number assigned to this NPI record is 34D2159224 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2006 and was last updated on 10/16/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometrist2000-00102NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12330965MEDICARE PINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.