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General NPI Number Information
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NPI Number | 1639242068
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Entity Type | Organization
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Legal Business Name | EYECARECENTER OD PA
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 4811 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2111
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Country | US
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Telephone | 636-200-4393
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Fax | 910-739-6489
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Provider Business Mailing Address
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Address Line | PO BOX 207261
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City | DALLAS
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State | TX
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Zip | 75320-7261
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Country | US
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Telephone | 636-200-4393
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Fax | 636-527-0766
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALISON BAILEY
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Credential | OD
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Telephone | 636-200-4393
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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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