Provider Demographics
NPI:1245588557
Name:NELSON C KLAUS JR OD
Entity Type:Organization
Organization Name:NELSON C KLAUS JR OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLAUS
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:910-799-0220
Mailing Address - Street 1:3910 SHIPYARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6151
Mailing Address - Country:US
Mailing Address - Phone:910-799-0220
Mailing Address - Fax:
Practice Address - Street 1:3910 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6151
Practice Address - Country:US
Practice Address - Phone:910-799-0220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty