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NPI Code Detail

MEDICARE: GASTON EYE ASSOCIATES

MEDICARE: GASTON EYE ASSOCIATES
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
1332H00000XEyewear Supplier
2152W00000XOptometrist
3207W00000XOphthalmology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150344OTHERNCMEDCOST
20185BOTHERNCBLUE CROSS OF NC
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4NONEOTHERNCPARTNERS
5NONEOTHERNCTRICARE

General Provider Information

NPI Number : 1417945775
Entity Type Code : Organization
Provider Name (Legal Business Name) : GASTON EYE ASSOCIATES
Provider Business Mailing Address
First Line : 2325 ABERDEEN BLVD
Second Line : STE A
City : GASTONIA
State : NC
Zip : 28054-0614
Country : US
Telephone Number : 704-853-3937
Fax Number : 704-853-0840
Provider Business Practice Location Address
First Line : 2325 ABERDEEN BLVD
Second Line : STE A
City : GASTONIA
State : NC
Zip : 28054-0614
Country : US
Telephone Number : 704-853-3937
Fax Number : 704-853-0840
Authorized Official
Title or Position : MANAGING PARTNER
Name : DR. BOB MCCULLEN JR.
Credential : M.D.
Telephone Number : 704-853-3937
Provider Enumeration Date : 10/11/2005
Last Update Date : 08/04/2008

Similar Medicare Providers

1457354284 — DR. BOBBY KENNETH MCCULLEN JR. M.D.
Practice Location Address:
2325 ABERDEEN BLVD , STE A
GASTONIA, NC
28054-0614
Practice Phone: 704-853-3937
Practice Fax: 704-853-0840
1568469641 — DR. MARTIN TODD BROWN M.D.
Practice Location Address:
2325 ABERDEEN BLVD , STE A
GASTONIA, NC
28054-0614
Practice Phone: 704-853-3937
Practice Fax: 704-853-0840
1659379394 — DR. MICHAEL JAMES LUND M.D.
Practice Location Address:
2325 ABERDEEN BLVD , STE A
GASTONIA, NC
28054-0614
Practice Phone: 704-853-3937
Practice Fax: 704-853-0840
1023018041 — DR. ROBERT LEE SULLIVAN O.D.
Practice Location Address:
2325 ABERDEEN BLVD , SUITE A
GASTONIA, NC
28054-0614
Practice Phone: 704-853-3937
Practice Fax: 704-853-0840
1669464442 — DR. JOHN PHILIP FOSTER O.D.
Practice Location Address:
2325 ABERDEEN BLVD
GASTONIA, NC
28054-0614
Practice Phone: 704-853-3937
Practice Fax: 704-853-0840
1255324034 — DR. REY GARRIDO O.D.
Practice Location Address:
2325 ABERDEEN BLVD
GASTONIA, NC
28054-0614
Practice Phone: 704-853-3937
Practice Fax: 704-853-8029

Directions to “GASTON EYE ASSOCIATES ” Practice Location

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