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NPI Code Detail

MEDICARE: EMILY RAYNOR DAVIS OD

MEDICARE: EMILY RAYNOR DAVIS 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
1152W00000XOptometrist2649NC

General Provider Information

NPI Number : 1649865932
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY RAYNOR DAVIS OD
Provider Business Mailing Address
First Line : 3701 S MAIN ST
Second Line :
City : HOPE MILLS
State : NC
Zip : 28348-1958
Country : US
Telephone Number : 910-429-5434
Fax Number : 910-423-0974
Provider Business Practice Location Address
First Line : 3701 S MAIN ST
Second Line :
City : HOPE MILLS
State : NC
Zip : 28348-1958
Country : US
Telephone Number : 910-429-5434
Fax Number : 910-423-0974
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2021
Last Update Date : 11/15/2024

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