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NPI Code Detail

MEDICARE: BURGAW EYE CENTER, O.D., P.A.

MEDICARE: BURGAW EYE CENTER, O.D., P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2025NC

General Provider Information

NPI Number : 1013244326
Entity Type Code : Organization
Provider Name (Legal Business Name) : BURGAW EYE CENTER, O.D., P.A.
Provider Business Mailing Address
First Line : PO BOX 787
Second Line :
City : BURGAW
State : NC
Zip : 28425-0787
Country : US
Telephone Number : 910-259-5661
Fax Number :
Provider Business Practice Location Address
First Line : 106 EAST SATCHWELL STREET
Second Line :
City : BURGAW
State : NC
Zip : 28425-5064
Country : US
Telephone Number : 910-259-5661
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. KYLE A EATON
Credential : O.D.
Telephone Number : 704-779-8168
Provider Enumeration Date : 11/06/2009
Last Update Date : 11/06/2009

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Directions to “BURGAW EYE CENTER, O.D., P.A. ” Practice Location

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