Provider Demographics
NPI:1992044473
Name:DR JOANN TODD & ASSOCIATES OF OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:DR JOANN TODD & ASSOCIATES OF OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-658-2020
Mailing Address - Street 1:1122 N BREAZEALE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT OLIVE
Mailing Address - State:NC
Mailing Address - Zip Code:28365-1121
Mailing Address - Country:US
Mailing Address - Phone:919-658-2020
Mailing Address - Fax:919-658-0487
Practice Address - Street 1:1122 N BREAZEALE AVE
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-1121
Practice Address - Country:US
Practice Address - Phone:919-658-2020
Practice Address - Fax:919-658-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-04
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2138152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty