Provider Demographics
NPI:1336339845
Name:MILLS & SALTER SMITHFIELD O.D. P.A.
Entity Type:Organization
Organization Name:MILLS & SALTER SMITHFIELD O.D. P.A.
Other - Org Name:DOCTORS VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DERRIL
Authorized Official - Last Name:SALTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-938-6101
Mailing Address - Street 1:671 CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5585
Mailing Address - Country:US
Mailing Address - Phone:919-359-2656
Mailing Address - Fax:919-550-3238
Practice Address - Street 1:1690 BOOKER DAIRY RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9405
Practice Address - Country:US
Practice Address - Phone:919-938-6101
Practice Address - Fax:919-938-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1556152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC019MYOtherBCBS
NC232214OtherMEDICARE
NC2816118OtherUHC
NC8802123Medicaid
NC=========OtherSVS
NC=========OtherSVS