Healthcare Provider Details

I. General information

NPI: 1770764946
Provider Name (Legal Business Name): FIRST CHOICE EYE CARE, OD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14617 LAWYERS RD SUITE A
MATTHEWS NC
28104-3219
US

IV. Provider business mailing address

14617 LAWYERS RD SUITE A
MATTHEWS NC
28104-3219
US

V. Phone/Fax

Practice location:
  • Phone: 704-893-0090
  • Fax: 704-893-0944
Mailing address:
  • Phone: 704-893-0090
  • Fax: 704-893-0944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN D BIGHAM
Title or Position: OPTOMETRIST
Credential: OD
Phone: 704-893-0090