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General NPI Number Information
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NPI Number | 1124136874
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Entity Type | Organization
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Legal Business Name | NORTH WAKE EYE CARE, DR. STEPHEN J. MERCKLE O.D., P.A.
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/25/2008
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Provider Practice Location Address
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Address Line | 220 SOUTHTOWN CIRCLE
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City | ROLESVILLE
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State | NC
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Zip | 27571
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Country | US
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Telephone | 919-554-2440
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Fax | 919-554-1571
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Provider Business Mailing Address
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Address Line | 220 SOUTHTOWN CIRCLE
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City | ROLESVILLE
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State | NC
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Zip | 27571
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Country | US
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Telephone | 919-554-2440
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Fax | 919-554-1571
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN J. MERCKLE
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Credential | O.D.
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Telephone | 919-554-2440
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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 | 1833
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License Number State | NC
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