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1144211483

NPI Code Detail

MEDICARE: DAVID BRENNEN THRONEBURG OD

MEDICARE: DAVID BRENNEN THRONEBURG OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1693	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	NCK7580355	OTHER	NC	MEDICARE
7	180034437	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2238830	OTHER	NC	UNITED HEALTHCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0906W	OTHER	NC	BCBS
4	FH7000015	OTHER	NC	FIRSTCAROLINACARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	368226	OTHER	NC	USA MANAGED CARE
9	370068	OTHER	NC	MAMSI
10	124971	OTHER	NC	OPTICARE
11	86924	OTHER	NC	MEDCOST

General Provider Information

NPI Number	:	1144211483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BRENNEN THRONEBURG OD

Provider Business Mailing Address
First Line	:	2170 MIDLAND RD
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-2927
Country	:	US
Telephone Number	:	910-295-2100
Fax Number	:	910-295-3625

Provider Business Practice Location Address
First Line	:	2170 MIDLAND RD
Second Line	:
City	:	SOUTHERN PINES
State	:	NC
Zip	:	28387-2927
Country	:	US
Telephone Number	:	910-295-2100
Fax Number	:	910-295-3625

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	12/20/2023

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Directions to “ DAVID BRENNEN THRONEBURG OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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