Provider Demographics
NPI:1962451336
Name:NAVON, SAMUEL EDWARD
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:EDWARD
Last Name:NAVON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2300
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2300
Mailing Address - Country:US
Mailing Address - Phone:828-693-1773
Mailing Address - Fax:828-692-3297
Practice Address - Street 1:1701 OLD VILLAGE RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3772
Practice Address - Country:US
Practice Address - Phone:828-693-1773
Practice Address - Fax:828-692-3297
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000285207W00000X
SC21706207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8912571Medicaid
NC2280173EMedicare ID - Type UnspecifiedMEDICARE
NCF51167Medicare UPIN
NC8912571Medicaid