Provider Demographics
NPI:1437708393
Name:HEARN, PAUL BRADFORD (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BRADFORD
Last Name:HEARN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16525 BIRKDALE COMMONS PKWY
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3802
Mailing Address - Country:US
Mailing Address - Phone:704-896-3311
Mailing Address - Fax:704-896-5514
Practice Address - Street 1:16525 BIRKDALE COMMONS PKWY
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3802
Practice Address - Country:US
Practice Address - Phone:704-896-3311
Practice Address - Fax:704-896-5514
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC2572152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist