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General NPI Number Information
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NPI Number | 1023732864
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Entity Type | Organization
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Legal Business Name | ELIZABETH A WINDLEY O.D. PLLC
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 5070 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2108
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Country | US
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Telephone | 910-608-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 4901 WHITE OAK DR
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City | LUMBERTON
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State | NC
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Zip | 28358-2187
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Country | US
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Telephone | 843-907-9780
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ELIZABETH ANNE WINDLEY
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Credential |
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Telephone | 843-907-9780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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