Healthcare Provider Details

I. General information

NPI: 1497949887
Provider Name (Legal Business Name): DRS. LOFLIN AND BYRNES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 N ELM ST SUITE 101
GREENSBORO NC
27401-2177
US

IV. Provider business mailing address

338 N ELM ST SUITE 101
GREENSBORO NC
27401-2177
US

V. Phone/Fax

Practice location:
  • Phone: 336-272-5252
  • Fax: 336-272-0939
Mailing address:
  • Phone: 336-272-5252
  • Fax: 336-272-0939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0911
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number0911
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0911
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number0911
License Number StateNC

VIII. Authorized Official

Name: DR. CHARLES FRANCES BYRNES
Title or Position: DOCTOR
Credential: O.D.
Phone: 336-272-5252