Provider Demographics
NPI:1922063304
Name:CABARRUS EYE CENTER PA
Entity Type:Organization
Organization Name:CABARRUS EYE CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:K
Authorized Official - Last Name:LARK
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:704-782-1127
Mailing Address - Street 1:201 LEPHILLIP COURT NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2900
Mailing Address - Country:US
Mailing Address - Phone:704-782-1127
Mailing Address - Fax:704-782-1207
Practice Address - Street 1:201 LEPHILLIP COURT NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2900
Practice Address - Country:US
Practice Address - Phone:704-782-1127
Practice Address - Fax:704-782-1207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39721207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCCA3344OtherMEDICARE RAILROAD
NC8901147Medicaid
NC01147OtherBLUE CROSS BLUE SHIELD
NC01147OtherBLUE CROSS BLUE SHIELD
NC8901147Medicaid