Provider Demographics
NPI:1346201845
Name:HIGH, CHARLOTTE A (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLOTTE
Middle Name:A
Last Name:HIGH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NASH MEDICAL ARTS MALL
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-1415
Mailing Address - Country:US
Mailing Address - Phone:252-443-1006
Mailing Address - Fax:252-937-8366
Practice Address - Street 1:400 NASH MEDICAL ARTS MALL
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-1415
Practice Address - Country:US
Practice Address - Phone:252-443-1006
Practice Address - Fax:252-937-8366
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1030152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC09388OtherBCBS
NC8909388Medicaid
NC246331AMedicare ID - Type Unspecified
NCT64874Medicare UPIN