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General NPI Number Information
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NPI Number | 1659821528
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Entity Type | Organization
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Legal Business Name | REFOCUS EYE CARE, PLLC
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/04/2016
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Provider Practice Location Address
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Address Line | 515 MOUNT CROSS RD
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City | DANVILLE
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State | VA
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Zip | 24540-4065
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Country | US
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Telephone | 224-725-8423
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 BAITY HILL DR APT 126
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City | CHAPEL HILL
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State | NC
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Zip | 27514-3956
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Country | US
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Telephone | 224-725-8423
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. HAFEEZAH OMAR
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Credential | OD
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Telephone | 224-725-8423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 0618002517
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License Number State | VA
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