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General NPI Number Information
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NPI Number | 1548409576
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Entity Type | Organization
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Legal Business Name | VISION CARE ASSOCIATES, OD, PA
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Dates
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Enumeration Date | 02/15/2009
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Last Update Date | 02/14/2020
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Provider Practice Location Address
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Address Line | 3419 PINEVILLE MATTHEWS RD
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City | CHARLOTTE
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State | NC
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Zip | 28226-9305
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Country | US
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Telephone | 704-541-0468
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Fax | 704-542-0318
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Provider Business Mailing Address
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Address Line | 3419 PINEVILLE MATTHEWS RD
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City | CHARLOTTE
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State | NC
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Zip | 28226-9305
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Country | US
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Telephone | 704-541-0468
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Fax | 704-542-0318
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MARK W GIFFORD
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Credential | OD
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Telephone | 704-541-0468
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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 | 2112
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License Number State | NC
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