Healthcare Provider Details

I. General information

NPI: 1093629446
Provider Name (Legal Business Name): PEE DEE VALLEY EYECARE OD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 ALBEMARLE RD
TROY NC
27371-3206
US

IV. Provider business mailing address

326 ALBEMARLE RD
TROY NC
27371-3206
US

V. Phone/Fax

Practice location:
  • Phone: 910-576-7371
  • Fax: 910-576-7372
Mailing address:
  • Phone: 910-576-7371
  • Fax: 910-576-7372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CARLYLE D HAYWOOD JR.
Title or Position: SOLE MEMBER
Credential: OD
Phone: 910-576-7371