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General NPI Number Information
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NPI Number | 1336299684
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Entity Type | Organization
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Legal Business Name | BLADEN EYE CENTER, O.D., P.A.
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 409 EAST BROAD STREET
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-2589
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Country | US
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Telephone | 910-862-4268
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Fax | 910-862-2057
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Provider Business Mailing Address
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Address Line | PO BOX 2589
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-2589
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Country | US
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Telephone | 910-862-4268
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Fax | 910-862-2057
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Authorized Official
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Title or Position | OD
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Name | ERIC E SCHMIDT
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Credential |
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Telephone | 910-862-4268
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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 | 1447
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License Number State | NC
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