Provider Demographics
NPI:1528559812
Name:JMP OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:JMP OPTOMETRY, PLLC
Other - Org Name:ACADEMY EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OD / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-493-7456
Mailing Address - Street 1:910 MARTIN LUTHER KING JR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-2655
Mailing Address - Country:US
Mailing Address - Phone:919-942-8531
Mailing Address - Fax:919-942-0719
Practice Address - Street 1:910 MARTIN LUTHER KING JR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2655
Practice Address - Country:US
Practice Address - Phone:919-942-8531
Practice Address - Fax:919-942-0719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2043152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty