MEDICARE: MRS. LAUREN SCHAMBS WOODWORTH O.D.

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	2128	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538317979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAUREN SCHAMBS WOODWORTH O.D.

Provider Business Mailing Address
First Line	:	8313 S NC 55 HWY
Second Line	:
City	:	WILLOW SPRING
State	:	NC
Zip	:	27592-9543
Country	:	US
Telephone Number	:	919-639-2020
Fax Number	:	919-639-8505

Provider Business Practice Location Address
First Line	:	8313 S NC 55 HWY
Second Line	:
City	:	WILLOW SPRING
State	:	NC
Zip	:	27592-9543
Country	:	US
Telephone Number	:	919-639-2020
Fax Number	:	919-639-8505

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

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	01/20/2011

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