Healthcare Provider Details

I. General information

NPI: 1649331018
Provider Name (Legal Business Name): APEX OPTOMETRY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 BEAVER CREEK COMMONS DR
APEX NC
27502-3918
US

IV. Provider business mailing address

1049 BEAVER CREEK COMMONS DR
APEX NC
27502-3918
US

V. Phone/Fax

Practice location:
  • Phone: 919-367-7889
  • Fax: 919-249-4079
Mailing address:
  • Phone: 919-367-7889
  • Fax: 919-249-4079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2031
License Number StateNC

VIII. Authorized Official

Name: DR. SUSAN L DURHAM
Title or Position: DIRECTOR
Credential: D.O.
Phone: 919-467-3238