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General NPI Number Information
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NPI Number | 1508111329
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Entity Type | Organization
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Legal Business Name | S&S OPTOMETRIC SERVICES PLLC
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 476 SHOTWELL RD STE 104
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City | CLAYTON
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State | NC
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Zip | 27520-3506
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Country | US
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Telephone | 919-553-8181
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Fax | 919-359-1504
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Provider Business Mailing Address
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Address Line | 476 SHOTWELL RD STE 104
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City | CLAYTON
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State | NC
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Zip | 27520-3506
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Country | US
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Telephone | 919-553-8181
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Fax | 919-359-1504
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY SCOTT WILKINS
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Credential | O.D.
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Telephone | 919-553-8181
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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 | 1972
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License Number State | NC
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