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General NPI Number Information
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NPI Number | 1184641813
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Entity Type | Organization
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Legal Business Name | BATTLEGROUND EYE CARE, OD, PA
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 3132 BATTLEGROUND AVE STE B
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City | GREENSBORO
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State | NC
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Zip | 27408-1915
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Country | US
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Telephone | 336-282-2273
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Fax | 336-282-5325
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Provider Business Mailing Address
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Address Line | 3132 BATTLEGROUND AVE STE B
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City | GREENSBORO
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State | NC
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Zip | 27408-1915
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Country | US
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Telephone | 336-282-2273
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Fax | 336-282-5325
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON B. SCOTT
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Credential | OD
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Telephone | 336-282-2273
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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 | 1876
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License Number State | NC
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