Healthcare Provider Details

I. General information

NPI: 1699863068
Provider Name (Legal Business Name): CAROLINA EYE CARE OF LINCOLN COUNTY OPTOMETRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 N HIGHWAY 16
DENVER NC
28037-7574
US

IV. Provider business mailing address

623 N HIGHWAY 16
DENVER NC
28037-7574
US

V. Phone/Fax

Practice location:
  • Phone: 704-483-2263
  • Fax: 704-483-6136
Mailing address:
  • Phone: 704-483-2263
  • Fax: 704-483-6136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN SCOTT NISHEK
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 704-735-7101