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General NPI Number Information
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NPI Number | 1104235001
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Entity Type | Organization
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Legal Business Name | CAPITAL EYE CENTER
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Dates
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Enumeration Date | 08/05/2014
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 720 WEST JONES ST
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City | RALEIGH
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State | NC
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Zip | 27612
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Country | US
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Telephone | 919-834-7341
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Fax |
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Provider Business Mailing Address
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Address Line | 720 W JONES ST
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City | RALEIGH
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State | NC
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Zip | 27603-1427
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Country | US
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Telephone | 919-834-7341
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT ROGERS MUNN III
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Credential | M.D.
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Telephone | 919-834-7341
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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 | 30564
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License Number State | NC
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