Provider Demographics
NPI:1275508152
Name:ASSELL, JOHN MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:ASSELL
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:7547 WATERSIDE LOOP RD
Mailing Address - Street 2:STE A
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037
Mailing Address - Country:US
Mailing Address - Phone:704-822-9920
Mailing Address - Fax:704-822-1764
Practice Address - Street 1:7547 WATERSIDE LOOP RD
Practice Address - Street 2:STE A
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037
Practice Address - Country:US
Practice Address - Phone:701-822-9920
Practice Address - Fax:704-822-1764
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2019-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NCNC1850152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
135UFOtherNC BLUE SHIELD
2120530OtherALLIANCE PPO LLC
861063250OtherUNITED AMERICAN
861063250OtherCONTINENTAL GENERAL
NC891356FMedicaid
89135UFOtherNC MEDICAID
861063250OtherAIG
861063250OtherHEALTH CARE SAVINGS
861063250OtherWELLPATH SELECT INC
861063250OtherGUARANTEE TRUST LIFE
861063250OtherFIRST HEALTH NETWORK
861083250OtherADVANCED BENEFIT
805963OtherCOMMUNITY EYE CARE
861063250OtherUNITED TEACHERS
2335465OtherNCMEDICARE
861063250OtherUNITED HEALTH CARE
861063250OtherCHAMPVA