Provider Demographics
NPI:1629302005
Name:PERRY, HALEY A (OD)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:A
Last Name:PERRY
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 1:140 AIRPORT RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704
Mailing Address - Country:US
Mailing Address - Phone:828-687-7500
Mailing Address - Fax:828-687-7333
Practice Address - Street 1:140 AIRPORT RD
Practice Address - Street 2:SUITE L
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704
Practice Address - Country:US
Practice Address - Phone:828-687-7500
Practice Address - Fax:828-687-7333
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC2164OtherSTATE LIC
NC1597HOtherBLUE CROSS BLUE SHIELD
NC5918058Medicaid
6583700001Medicare NSC
NC4070A644Medicare PIN