Provider Demographics
NPI:1396845665
Name:HOWARD EYE ASSOCIATES, OD PA
Entity Type:Organization
Organization Name:HOWARD EYE ASSOCIATES, OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:910-457-6667
Mailing Address - Street 1:4961 LONG BEACH RD SE STE 8
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-8001
Mailing Address - Country:US
Mailing Address - Phone:910-457-6667
Mailing Address - Fax:910-457-9530
Practice Address - Street 1:4961 LONG BEACH RD SE STE 8
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-8001
Practice Address - Country:US
Practice Address - Phone:910-457-6667
Practice Address - Fax:910-457-9530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014U1Medicaid
NC014U1OtherBLUE CROSS GROUP NUMBER
NC89014U1Medicaid