Provider Demographics
NPI:1487664033
Name:MORGANTON EYE PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:MORGANTON EYE PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
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:OPTICAL DEPARTMENT
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:OPTICAL DEPARTMENT
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:2006-08-08
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8802040Medicaid
NC0392190010Medicare NSC
NCCA0058Medicare PIN