Healthcare Provider Details

I. General information

NPI: 1003337593
Provider Name (Legal Business Name): COURTNEY GREGG OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: COURTNEY STUCK

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SAWMILL RD
RALEIGH NC
27615-6148
US

IV. Provider business mailing address

500 N WEST ST UNIT 541
RALEIGH NC
27603-5082
US

V. Phone/Fax

Practice location:
  • Phone: 919-847-0051
  • Fax:
Mailing address:
  • Phone: 574-607-1660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2839
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: