MEDICARE: SILER CROSSING VISION CENTER OPTOMETRY 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	NC1661	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235173527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILER CROSSING VISION CENTER OPTOMETRY PA

Provider Business Mailing Address
First Line	:	1603 E 11TH ST
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-2823
Country	:	US
Telephone Number	:	919-742-5007
Fax Number	:	919-742-4599

Provider Business Practice Location Address
First Line	:	1603 E 11TH ST
Second Line	:
City	:	SILER CITY
State	:	NC
Zip	:	27344-2823
Country	:	US
Telephone Number	:	919-742-5007
Fax Number	:	919-742-4599

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAY ALLEN HAGER JR.
Credential	:	OD
Telephone Number	:	919-742-5007

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	06/28/2010

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Directions to “SILER CROSSING VISION CENTER OPTOMETRY PA ” Practice Location

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