MEDICARE: RONALD G. AMAKER & ASSOCIATES, OD, PA

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
1	152W00000X	Optometrist	1284	NC

General Provider Information

NPI Number	:	1093847477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RONALD G. AMAKER & ASSOCIATES, OD, PA

Provider Business Mailing Address
First Line	:	845 BLOWING ROCK BLVD STE R
Second Line	:	P.O. BOX 1864
City	:	LENOIR
State	:	NC
Zip	:	28645-3757
Country	:	US
Telephone Number	:	828-757-2816
Fax Number	:	828-757-2864

Provider Business Practice Location Address
First Line	:	845 BLOWING ROCK BLVD STE R
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-3757
Country	:	US
Telephone Number	:	828-757-2816
Fax Number	:	828-757-2864

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONALD AMAKER
Credential	:	O.D.
Telephone Number	:	828-757-2816

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/22/2020

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