Healthcare Provider Details

I. General information

NPI: 1245025048
Provider Name (Legal Business Name): GRAYSTONE OPHTHALMOLOGY ASSOCIATES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 BOONE TRL
NORTH WILKESBORO NC
28659-3515
US

IV. Provider business mailing address

PO BOX 3445
HICKORY NC
28603-3445
US

V. Phone/Fax

Practice location:
  • Phone: 336-667-3288
  • Fax:
Mailing address:
  • Phone: 828-322-2050
  • Fax: 828-345-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW P TATE
Title or Position: CEO
Credential:
Phone: 828-304-6701