Provider Demographics
NPI:1629165196
Name:HOYLE, KIMBERLY Z (OD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:Z
Last Name:HOYLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7547 WATERSIDE LOOP RD STE A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:NC
Mailing Address - Zip Code:28037-7678
Mailing Address - Country:US
Mailing Address - Phone:704-822-9920
Mailing Address - Fax:704-822-1764
Practice Address - Street 1:7547 WATERSIDE LOOP RD STE A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:NC
Practice Address - Zip Code:28037-7678
Practice Address - Country:US
Practice Address - Phone:704-822-9920
Practice Address - Fax:704-822-1764
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2046152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093VTOtherBCBSNC PIN
NC5906690Medicaid
NC093VTOtherBCBSNC PIN
NC5906690Medicaid