MEDICARE: FRIENDLY EYES OF NORTH CAROLINA

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

General Provider Information

NPI Number	:	1467387886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIENDLY EYES OF NORTH CAROLINA

Provider Business Mailing Address
First Line	:	534 E ZARAGOZA ST APT 7
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32502-6100
Country	:	US
Telephone Number	:	267-566-4109
Fax Number	:

Provider Business Practice Location Address
First Line	:	5415 WASHINGTON PIKE
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-7004
Country	:	US
Telephone Number	:	865-544-1677
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BARRY CONCOOL
Credential	:	MD
Telephone Number	:	267-566-4109

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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