Provider Demographics
NPI:1568443349
Name:CURTIS, DAVID LAMAR (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LAMAR
Last Name:CURTIS
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 1:324 N HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-8012
Mailing Address - Country:US
Mailing Address - Phone:704-483-2263
Mailing Address - Fax:704-483-6136
Practice Address - Street 1:324 N HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-8012
Practice Address - Country:US
Practice Address - Phone:704-483-2263
Practice Address - Fax:704-483-6136
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0876152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890979BMedicaid
NC890979BMedicaid
NC246252FMedicare ID - Type Unspecified