MEDICARE: STEPHANIE JOHNSON CARTWRIGHT, O.D. PLLC

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	332H00000X	Eyewear Supplier	1908	NC

General Provider Information

NPI Number	:	1497982482
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHANIE JOHNSON CARTWRIGHT, O.D. PLLC

Provider Business Mailing Address
First Line	:	1816 N BRIDGE ST
Second Line	:
City	:	ELKIN
State	:	NC
Zip	:	28621-2104
Country	:	US
Telephone Number	:	336-835-2244
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 N BRIDGE ST
Second Line	:
City	:	ELKIN
State	:	NC
Zip	:	28621-2104
Country	:	US
Telephone Number	:	336-835-2244
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. STEPHANIE JOHNSON CARTWRIGHT
Credential	:	O.D.
Telephone Number	:	336-835-2244

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	06/17/2009

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