Healthcare Provider Details

I. General information

NPI: 1851578371
Provider Name (Legal Business Name): EYE CARE ASSOCIATES OD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 04/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N DUKE ST SUITE 1
DURHAM NC
27704-1707
US

IV. Provider business mailing address

7100 SIX FORKS RD SUITE 301
RALEIGH NC
27615-6156
US

V. Phone/Fax

Practice location:
  • Phone: 919-595-2020
  • Fax: 919-226-3735
Mailing address:
  • Phone: 919-847-0187
  • Fax: 919-676-2231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEPHEN F BOLICK
Title or Position: CEO
Credential: OD
Phone: 919-847-0187