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General NPI Number Information
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NPI Number | 1174850168
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Entity Type | Organization
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Legal Business Name | ACCUVISION EYE CARE OD, PA
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Dates
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Enumeration Date | 11/11/2009
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Last Update Date | 09/14/2022
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Provider Practice Location Address
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Address Line | 3916 E FRANKLIN BLVD STE 160
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City | GASTONIA
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State | NC
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Zip | 28056-9220
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Country | US
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Telephone | 704-565-0660
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Fax | 704-824-2192
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Provider Business Mailing Address
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Address Line | 3916 E FRANKLIN BLVD STE 160
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City | GASTONIA
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State | NC
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Zip | 28056-9220
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Country | US
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Telephone | 704-565-0660
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Fax | 704-824-2192
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH ALLAN PAWLISH JR.
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Credential | O.D.
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Telephone | 704-565-0660
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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 | 2042
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License Number State | NC
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