Provider Demographics
NPI:1083355184
Name:RALEIGH OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:RALEIGH OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDGINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-781-2116
Mailing Address - Street 1:8901 RIVERVIEW PARK DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-5391
Mailing Address - Country:US
Mailing Address - Phone:919-272-2541
Mailing Address - Fax:
Practice Address - Street 1:2501 ATRIUM DR STE 150
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6674
Practice Address - Country:US
Practice Address - Phone:919-781-2116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty