Healthcare Provider Details

I. General information

NPI: 1790874329
Provider Name (Legal Business Name): GUILFORD EYE CENTER OD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 W FRIENDLY AVE SUITE 200
GREENSBORO NC
27410-4368
US

IV. Provider business mailing address

5500 W FRIENDLY AVE SUITE 200
GREENSBORO NC
27410-4368
US

V. Phone/Fax

Practice location:
  • Phone: 336-292-4516
  • Fax: 336-292-5706
Mailing address:
  • Phone: 336-292-4516
  • Fax: 336-292-5706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. GEORGE S THURMOND
Title or Position: OWNER
Credential: OD
Phone: 336-292-4516