Provider Demographics
NPI:1174859268
Name:OPTIMAL CHOICE GROUP INC
Entity Type:Organization
Organization Name:OPTIMAL CHOICE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:FURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-756-1963
Mailing Address - Street 1:15105 JOHN J DELANEY DR
Mailing Address - Street 2:SUITE D 29
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15105 JOHN J DELANEY DR
Practice Address - Street 2:SUITE D 29
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2847
Practice Address - Country:US
Practice Address - Phone:704-756-1963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty