Healthcare Provider Details

I. General information

NPI: 1881952810
Provider Name (Legal Business Name): GRAYSTONE OPHTHALMOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2012
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 HIGHWAY 105 STE 102
BOONE NC
28607-7828
US

IV. Provider business mailing address

PO BOX 3445
HICKORY NC
28603-3445
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-2050
  • Fax: 828-345-0522
Mailing address:
  • Phone: 828-304-6602
  • Fax: 828-345-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number38977
License Number StateNC

VIII. Authorized Official

Name: MR. ANDREW P TATE
Title or Position: CEO
Credential:
Phone: 828-304-6701