Provider Demographics
NPI:1851381289
Name:BENFIELD, EUGENE EVERETTE III (OD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:EVERETTE
Last Name:BENFIELD
Suffix:III
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 1:1971 TURNER RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-8194
Mailing Address - Country:US
Mailing Address - Phone:336-601-8829
Mailing Address - Fax:
Practice Address - Street 1:495 US HIGHWAY 158 W
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379-8304
Practice Address - Country:US
Practice Address - Phone:336-694-9632
Practice Address - Fax:336-694-1207
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1977152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5903718Medicaid
NC5903718Medicaid
NC2473947Medicare ID - Type Unspecified