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General NPI Number Information
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NPI Number | 1336140730
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Entity Type | Individual
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Provider Name | CHARLES HAROLD ALDRIDGE JR. O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 419 E MAIN ST
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City | BURNSVILLE
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State | NC
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Zip | 28714-3050
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Country | US
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Telephone | 828-682-2104
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Fax | 828-682-4217
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Provider Business Mailing Address
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Address Line | 419 E MAIN ST PO BOX 218
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City | BURNSVILLE
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State | NC
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Zip | 28714-3050
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Country | US
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Telephone | 828-682-2104
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Fax | 828-682-4217
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1015
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License Number State | NC
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