Provider Demographics
NPI:1568602688
Name:HOMER, ESTHER L (OCULARIST)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:L
Last Name:HOMER
Suffix:
Gender:F
Credentials:OCULARIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 DEEPWATER DR
Mailing Address - Street 2:
Mailing Address - City:STELLA
Mailing Address - State:NC
Mailing Address - Zip Code:28582-9741
Mailing Address - Country:US
Mailing Address - Phone:800-579-6363
Mailing Address - Fax:252-393-6930
Practice Address - Street 1:1044 CEDAR POINT BLVD
Practice Address - Street 2:
Practice Address - City:CEDAR POINT
Practice Address - State:NC
Practice Address - Zip Code:28584-8019
Practice Address - Country:US
Practice Address - Phone:800-579-6363
Practice Address - Fax:252-393-6930
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1468156FX1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist