Provider Demographics
NPI:1285835298
Name:EYE IMAGES
Entity Type:Organization
Organization Name:EYE IMAGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KNOCHE
Authorized Official - Suffix:
Authorized Official - Credentials:OPT
Authorized Official - Phone:336-379-0428
Mailing Address - Street 1:2154 LAWNDALE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7102
Mailing Address - Country:US
Mailing Address - Phone:336-379-0428
Mailing Address - Fax:
Practice Address - Street 1:2154 LAWNDALE DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7102
Practice Address - Country:US
Practice Address - Phone:336-379-0428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC392332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0814410001Medicare ID - Type Unspecified