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General NPI Number Information
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NPI Number | 1851566772
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Entity Type | Organization
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Legal Business Name | BRAD HEARN OD PA
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 16525 BIRKDALE CMNS PKWY SUITE 100
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3802
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Country | US
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Telephone | 704-896-3311
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Fax | 704-896-5514
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Provider Business Mailing Address
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Address Line | 16525 BIRKDALE CMNS PKWY SUITE 100
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-3802
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Country | US
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Telephone | 704-896-3311
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Fax | 704-896-5514
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL BRADFORD HEARN
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Credential | O.D.
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Telephone | 704-896-3311
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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 | 1223
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License Number State | NC
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