Provider Demographics
NPI:1043511876
Name:MOUNTAIN EYE ASSOCIATES PLLC
Entity Type:Organization
Organization Name:MOUNTAIN EYE ASSOCIATES PLLC
Other - Org Name:MOUNTAIN EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-452-5816
Mailing Address - Street 1:486 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8026
Mailing Address - Country:US
Mailing Address - Phone:828-452-5816
Mailing Address - Fax:825-452-0373
Practice Address - Street 1:1898 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-2158
Practice Address - Country:US
Practice Address - Phone:828-456-2015
Practice Address - Fax:828-456-2017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNTAIN EYE ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-10
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0256VOtherBCBS
NC890256VMedicaid
NC890256VMedicaid