Provider Demographics
NPI:1366627150
Name:DURHAM EYE CARE ASSOICATES, OD PLLC
Entity Type:Organization
Organization Name:DURHAM EYE CARE ASSOICATES, OD PLLC
Other - Org Name:EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BOLICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-847-0187
Mailing Address - Street 1:4102 N ROXBORO ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-2122
Mailing Address - Country:US
Mailing Address - Phone:919-863-2020
Mailing Address - Fax:
Practice Address - Street 1:7020 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6430
Practice Address - Country:US
Practice Address - Phone:919-863-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty