Healthcare Provider Details
I. General information
NPI: 1598700114
Provider Name (Legal Business Name): GRAYSTONE OPHTHALMOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2424 CENTURY PL SE
HICKORY NC
28602-4031
US
IV. Provider business mailing address
PO BOX 3445
HICKORY NC
28603-3445
US
V. Phone/Fax
- Phone: 828-322-2050
- Fax: 828-345-0522
- Phone: 828-322-2050
- Fax: 828-345-0522
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ANDREW
P
TATE
Title or Position: CEO
Credential:
Phone: 828-304-6701