Healthcare Provider Details

I. General information

NPI: 1467472290
Provider Name (Legal Business Name): SUSAN YEE O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 HIGH POINT RD
GREENSBORO NC
27407-4628
US

IV. Provider business mailing address

3702 HIGH POINT RD
GREENSBORO NC
27407-4628
US

V. Phone/Fax

Practice location:
  • Phone: 336-854-2020
  • Fax: 336-852-9472
Mailing address:
  • Phone: 336-854-2020
  • Fax: 336-852-9472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number1926
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: