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General NPI Number Information
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NPI Number | 1477366870
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Entity Type | Organization
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Legal Business Name | TRIAD EYE ASSOCIATES OF KING PLLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 306 KIRBY RD
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City | KING
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State | NC
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Zip | 27021-9493
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Country | US
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Telephone | 336-983-4313
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4370
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City | ARCHDALE
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State | NC
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Zip | 27263-4370
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Country | US
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Telephone | 336-687-7730
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Fax | 336-434-6680
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Authorized Official
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Title or Position | DIRECTOR OF INSURANCE
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Name | LISA D MOODY
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Credential |
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Telephone | 336-687-7730
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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 |
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License Number State |
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