Provider Demographics
NPI:1740265644
Name:NEW HORIZONS SURGICAL EYE CENTERS PA
Entity type:Organization
Organization Name:NEW HORIZONS SURGICAL EYE CENTERS PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GEIGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:910-321-0356
Mailing Address - Street 1:810 ELM ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4152
Mailing Address - Country:US
Mailing Address - Phone:910-321-0356
Mailing Address - Fax:910-321-0359
Practice Address - Street 1:810 ELM ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4152
Practice Address - Country:US
Practice Address - Phone:910-321-0356
Practice Address - Fax:910-321-0359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20602208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0133TOtherBCBS
NC8935040Medicaid
NC8935049Medicaid
NC2192998BMedicare ID - Type UnspecifiedIND NUMBER
NC8935049Medicaid
NC8935040Medicaid