Provider Demographics
NPI:1316382773
Name:ABLOTT, CHARLOTTE INGLE (OD)
Entity Type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:INGLE
Last Name:ABLOTT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MS
Other - First Name:CHARLOTTE
Other - Middle Name:INGLE
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1305 LEES CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2601
Mailing Address - Country:US
Mailing Address - Phone:336-314-0747
Mailing Address - Fax:
Practice Address - Street 1:1601 BRENNER AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2515
Practice Address - Country:US
Practice Address - Phone:704-638-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2317152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist