Provider Demographics
NPI:1417080342
Name:MORGANTON EYE PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:MORGANTON EYE PHYSICIANS, P.A.
Other - Org Name:EYE SURGERY CENTER OF SHELBY
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER. MEPPA
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-433-1000
Mailing Address - Street 1:335 E PARKER RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-5112
Mailing Address - Country:US
Mailing Address - Phone:828-433-1000
Mailing Address - Fax:828-433-6274
Practice Address - Street 1:1622 E MARION ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4939
Practice Address - Country:US
Practice Address - Phone:704-482-2020
Practice Address - Fax:704-482-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC00602OtherBLUE CROSS BLUE SHIELD NC
NC3409894Medicaid
NC3409894Medicaid
NC2380539Medicare PIN