Healthcare Provider Details

I. General information

NPI: 1033411848
Provider Name (Legal Business Name): MOUNTAIN EYE ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2010
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 S MAIN ST
WAYNESVILLE NC
28786-2158
US

IV. Provider business mailing address

486 HOSPITAL DR
CLYDE NC
28721-8026
US

V. Phone/Fax

Practice location:
  • Phone: 828-456-2015
  • Fax: 828-456-2017
Mailing address:
  • Phone: 828-452-5816
  • Fax: 828-452-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ANDREW KRUEGER
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 828-452-5816