MEDICARE: DR. BONNIE E. AIKEN O.D.

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	1433	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	2468501C	OTHER	NC	MEDICARE ID
6	410046981	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0944842	OTHER	NC	OPICARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	0912X	OTHER	NC	BCBS OF NC
5	2472021	OTHER	NC	SECOND PTAN
7	296143	OTHER	NC	MAMSI

General Provider Information

NPI Number	:	1194789727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNIE E. AIKEN O.D.

Provider Business Mailing Address
First Line	:	2120 STATESVILLE BLVD.
Second Line	:	EYECARE CENTER
City	:	SALISBURY
State	:	NC
Zip	:	28147
Country	:	US
Telephone Number	:	704-636-0559
Fax Number	:	704-636-6627

Provider Business Practice Location Address
First Line	:	2120 STATESVILLE BLVD
Second Line	:	EYECARE CENTER
City	:	SALISBURY
State	:	NC
Zip	:	28147-1410
Country	:	US
Telephone Number	:	704-636-0559
Fax Number	:	704-636-6627

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	06/28/2012

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Directions to “ DR. BONNIE E. AIKEN O.D.” Practice Location

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