Provider Demographics
NPI:1780863662
Name:SALTER EYE ASSOCIATES, O.D., P.A.
Entity Type:Organization
Organization Name:SALTER EYE ASSOCIATES, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SALTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-359-2656
Mailing Address - Street 1:671 CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5585
Mailing Address - Country:US
Mailing Address - Phone:919-359-2656
Mailing Address - Fax:
Practice Address - Street 1:6325 FALLS OF NEUSE RD STE 1
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6809
Practice Address - Country:US
Practice Address - Phone:919-876-1418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2472186Medicare PIN