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General NPI Number Information
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NPI Number | 1023066040
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Entity Type | Organization
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Legal Business Name | ROCKINGHAM EYE ASSOCIATES PA
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 515 THOMPSON ST SUITE A
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City | EDEN
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State | NC
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Zip | 27288-5068
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Country | US
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Telephone | 336-627-5271
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Fax |
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Provider Business Mailing Address
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Address Line | 515 THOMPSON STREET SUITE A
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City | EDEN
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State | NC
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Zip | 27288-5068
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Country | US
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Telephone | 336-627-5271
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Fax | 336-623-5182
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARROLL F HAINES JR.
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Credential | MD
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Telephone | 336-627-5271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 26004
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License Number State | NC
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