Provider Demographics
NPI:1346329513
Name:PATRICK M. MCLAREN, O.D., P.A.
Entity Type:Organization
Organization Name:PATRICK M. MCLAREN, O.D., P.A.
Other - Org Name:DOCTORS VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MCLAREN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-658-0474
Mailing Address - Street 1:1122 N BREAZEALE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-1121
Mailing Address - Country:US
Mailing Address - Phone:919-658-0474
Mailing Address - Fax:919-658-0487
Practice Address - Street 1:1122 N BREAZEALE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-1121
Practice Address - Country:US
Practice Address - Phone:919-658-0474
Practice Address - Fax:919-658-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1896152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901790Medicaid
NC093NNOtherBCBS
NC2347785Medicare PIN