Healthcare Provider Details

I. General information

NPI: 1790764926
Provider Name (Legal Business Name): OPTOMETRIC ASSOCIATES, P. A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W HILL ST
WARSAW NC
28398-1816
US

IV. Provider business mailing address

112 W HILL ST
WARSAW NC
28398-1816
US

V. Phone/Fax

Practice location:
  • Phone: 910-293-7893
  • Fax: 910-293-4389
Mailing address:
  • Phone: 910-293-7893
  • Fax: 910-293-4389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN DUNCAN ROBINSON II
Title or Position: PRESIDENT
Credential: O. D.
Phone: 910-285-3167