=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215936885
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES H SINGLETARY O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2005
-----------------------------------------------------
Last Update Date | 05/22/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6970 NEXUS CT
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28304-2642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-426-3937
-----------------------------------------------------
Fax | 910-487-4800
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7027 SURREY RD
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28306-2557
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-864-8245
-----------------------------------------------------
Fax | 910-864-8245
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 1921
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------