Provider Demographics
NPI:1083768311
Name:C.V. SIKES,JR. & R.B. GOTSCHALK PTR
Entity Type:Organization
Organization Name:C.V. SIKES,JR. & R.B. GOTSCHALK PTR
Other - Org Name:FAMILY EYE CARE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOTSCHALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-774-3556
Mailing Address - Street 1:1225 CARTHAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-8984
Mailing Address - Country:US
Mailing Address - Phone:919-774-3556
Mailing Address - Fax:919-774-7356
Practice Address - Street 1:1225 CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-8984
Practice Address - Country:US
Practice Address - Phone:919-774-3556
Practice Address - Fax:919-774-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1190152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC410024402OtherRR MEDICARE L.SMITH OD
NC7909036Medicaid
NC7909832Medicaid
NCCF0172OtherRR MEDICARE PROVIDER #
NC09713OtherBCBSNC L. SMITH
NC410014666OtherRR MEDICARE R.GOTSCHALK
NC8909713Medicaid
NC09322OtherBCBSNC R. GOTCHALK
NC410014665OtherRR MEDICARE C. SIKES, JR.
NC09036OtherBCBSNC GROUP NUMBER
NC09832OtherBCBSNC CHARLES SIKES, JR
NC8909322Medicaid
NC410014665OtherRR MEDICARE C. SIKES, JR.
NCT64842Medicare UPIN
NC7909832Medicaid
NC246575Medicare ID - Type UnspecifiedROBERT B. GOTSCHALK OD
NC1185Medicare ID - Type UnspecifiedPROVIDER NUMBER GROUP
NCU35488Medicare UPIN
NC09832OtherBCBSNC CHARLES SIKES, JR
NCT65091Medicare UPIN