Provider Demographics
NPI:1033344825
Name:NORVILLE EYE CARE, O.D., P.A.
Entity Type:Organization
Organization Name:NORVILLE EYE CARE, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NORVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-372-1408
Mailing Address - Street 1:608 SAWCUT LN
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-1479
Mailing Address - Country:US
Mailing Address - Phone:919-372-1408
Mailing Address - Fax:919-372-1410
Practice Address - Street 1:1201 BEAVER CREEK COMMONS DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3922
Practice Address - Country:US
Practice Address - Phone:919-372-1408
Practice Address - Fax:919-372-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2038152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6249080001Medicare NSC