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General NPI Number Information
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NPI Number | 1184778136
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Entity Type | Organization
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Legal Business Name | CHARLES V. SIKES JR
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 210 W IVEY ST
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City | LILLINGTON
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State | NC
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Zip | 27546
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Country | US
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Telephone | 910-893-5711
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Fax | 910-893-4805
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Provider Business Mailing Address
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Address Line | PO BOX 430
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City | LILLINGTON
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State | NC
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Zip | 27546
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Country | US
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Telephone | 910-893-5711
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Fax | 910-893-4805
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES V. SIKES JR.
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Credential | O.D.
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Telephone | 910-893-5711
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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 | 0997
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License Number State | NC
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