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General NPI Number Information
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NPI Number | 1144372483
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Entity Type | Organization
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Legal Business Name | JODY DALE PAPAZEKOS OD
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 27 13TH AVE NE
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City | HICKORY
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State | NC
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Zip | 28601-3766
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Country | US
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Telephone | 828-322-3154
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Fax | 828-322-3154
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Provider Business Mailing Address
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Address Line | 27 13TH AVE NE
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City | HICKORY
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State | NC
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Zip | 28601-3766
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Country | US
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Telephone | 828-322-3154
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Fax | 828-322-3154
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Authorized Official
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Title or Position | OWNER, PHYSICAN
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Name | DR. JODY DALE PAPAZEKOS
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Credential | O. D.
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Telephone | 828-322-3154
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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 | 1670
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License Number State | NC
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