Provider Demographics
NPI:1225231756
Name:EDWARD L. PAUL, JR., O.D., PH.D., P.A.
Entity Type:Organization
Organization Name:EDWARD L. PAUL, JR., O.D., PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD, PHD
Authorized Official - Phone:910-256-6364
Mailing Address - Street 1:1613 MILITARY CUTOFF RD STE 230
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5745
Mailing Address - Country:US
Mailing Address - Phone:910-256-6364
Mailing Address - Fax:910-256-6617
Practice Address - Street 1:1613 MILITARY CUTOFF RD STE 230
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5745
Practice Address - Country:US
Practice Address - Phone:910-256-6364
Practice Address - Fax:910-256-6617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1227152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty