Provider Demographics
NPI:1205529351
Name:SILLS, MEREDITH JONES (OPTICIAN)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:JONES
Last Name:SILLS
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 NEWPOINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451
Mailing Address - Country:US
Mailing Address - Phone:910-383-1224
Mailing Address - Fax:910-383-1016
Practice Address - Street 1:1112 NEWPOINTE BLVD
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451
Practice Address - Country:US
Practice Address - Phone:910-383-1224
Practice Address - Fax:910-383-1016
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1002156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician