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General NPI Number Information
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NPI Number | 1649331018
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Entity Type | Organization
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Legal Business Name | APEX OPTOMETRY GROUP
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1049 BEAVER CREEK COMMONS DR
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City | APEX
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State | NC
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Zip | 27502-3918
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Country | US
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Telephone | 919-367-7889
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Fax | 919-249-4079
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Provider Business Mailing Address
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Address Line | 1049 BEAVER CREEK COMMONS DR
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City | APEX
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State | NC
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Zip | 27502-3918
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Country | US
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Telephone | 919-367-7889
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Fax | 919-249-4079
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SUSAN L DURHAM
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Credential | D.O.
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Telephone | 919-467-3238
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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 | 2031
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License Number State | NC
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