MEDICARE: INSIGHT OPTOMETRIC SERVICES 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	1505	NC

General Provider Information

NPI Number	:	1770624249
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT OPTOMETRIC SERVICES PA

Provider Business Mailing Address
First Line	:	300 CAMPEN RD STE A
Second Line	:
City	:	BEAUFORT
State	:	NC
Zip	:	28516-1500
Country	:	US
Telephone Number	:	910-353-0909
Fax Number	:	910-355-6949

Provider Business Practice Location Address
First Line	:	344 JACKSONVILLE MALL
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7350
Country	:	US
Telephone Number	:	910-353-0909
Fax Number	:	910-355-6949

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICK AUSTIN PATTERSON
Credential	:	O.D.
Telephone Number	:	252-838-8822

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	04/21/2009

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