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General NPI Number Information
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NPI Number | 1962521690
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Entity Type | Organization
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Legal Business Name | THURMOND EYE ASSOCIATES OD, PA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 12/07/2010
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Provider Practice Location Address
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Address Line | 310 S CHURCH ST
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City | BURLINGTON
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State | NC
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Zip | 27215-3711
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Country | US
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Telephone | 336-226-7357
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Fax | 336-227-8119
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Provider Business Mailing Address
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Address Line | 310 S CHURCH ST
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City | BURLINGTON
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State | NC
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Zip | 27215-3711
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Country | US
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Telephone | 336-226-7357
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Fax | 336-227-8119
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GEORGE SHERMAN THURMOND II
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Credential | O.D.
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Telephone | 336-226-7357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1402
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License Number State | NC
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