Healthcare Provider Details

I. General information

NPI: 1902857675
Provider Name (Legal Business Name): RALEIGH EYE CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 EXECUTIVE DR SUITE 111
RALEIGH NC
27609-7445
US

IV. Provider business mailing address

3320 EXECUTIVE DR SUITE 111
RALEIGH NC
27609-7445
US

V. Phone/Fax

Practice location:
  • Phone: 919-876-2427
  • Fax: 919-790-8423
Mailing address:
  • Phone: 919-876-2427
  • Fax: 919-790-8423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: LESLIE ARNOLD
Title or Position: BUSINESS MANAGER
Credential:
Phone: 919-876-2427