Provider Demographics
NPI:1649331018
Name:APEX OPTOMETRY GROUP
Entity type:Organization
Organization Name:APEX OPTOMETRY GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:919-467-3238
Mailing Address - Street 1:1049 BEAVER CREEK COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-3918
Mailing Address - Country:US
Mailing Address - Phone:919-367-7889
Mailing Address - Fax:919-249-4079
Practice Address - Street 1:1049 BEAVER CREEK COMMONS DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-3918
Practice Address - Country:US
Practice Address - Phone:919-367-7889
Practice Address - Fax:919-249-4079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC152W00000XOtherANGELA MACDONALD, OD NPI