Provider Demographics
NPI:1992392310
Name:CAROLINA EYE CARE HUNTERSVILLE OPTOMETRY PLLC
Entity Type:Organization
Organization Name:CAROLINA EYE CARE HUNTERSVILLE OPTOMETRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NISHEK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-641-9507
Mailing Address - Street 1:215 GILEAD RD
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-6820
Mailing Address - Country:US
Mailing Address - Phone:704-992-3937
Mailing Address - Fax:704-464-1488
Practice Address - Street 1:215 GILEAD RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6820
Practice Address - Country:US
Practice Address - Phone:704-992-3937
Practice Address - Fax:704-464-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty