Healthcare Provider Details

I. General information

NPI: 1245090729
Provider Name (Legal Business Name): HAILEY BROOKE DUNLOW OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1176 E CUTLAR XING
LELAND NC
28451-6426
US

IV. Provider business mailing address

1729 NEW HANOVER MEDICAL PARK DR
WILMINGTON NC
28403-5345
US

V. Phone/Fax

Practice location:
  • Phone: 910-763-3601
  • Fax:
Mailing address:
  • Phone: 910-763-3601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2874
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: