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NPI Code Detail

MEDICARE: DR. HOLLY ADAMS BENNETT O.D.

MEDICARE: DR. HOLLY ADAMS BENNETT 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
1152W00000XOptometrist2182NC

General Provider Information

NPI Number : 1932425402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HOLLY ADAMS BENNETT O.D.
Provider Business Mailing Address
First Line : 4170 FAYETTEVILLE RD
Second Line :
City : RALEIGH
State : NC
Zip : 27603-3606
Country : US
Telephone Number : 919-772-2020
Fax Number : 919-772-8818
Provider Business Practice Location Address
First Line : 4170 FAYETTEVILLE RD
Second Line :
City : RALEIGH
State : NC
Zip : 27603-3606
Country : US
Telephone Number : 919-772-2020
Fax Number : 919-772-8818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2010
Last Update Date : 11/02/2012

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