Provider Demographics
NPI:1831241728
Name:DR. JODY D PAPAZEKOS
Entity type:Organization
Organization Name:DR. JODY D PAPAZEKOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:PAPAZEKOS
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:828-322-3154
Mailing Address - Street 1:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-0231
Mailing Address - Country:US
Mailing Address - Phone:828-632-4566
Mailing Address - Fax:828-632-4566
Practice Address - Street 1:545 NC HIGHWAY 16 S
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28681-9986
Practice Address - Country:US
Practice Address - Phone:828-632-4566
Practice Address - Fax:828-632-4566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0913UOtherBCBS PROVIDER #
NC890913UMedicaid
NC119986000OtherDMERC PROVIDER NUMBER
NC2470702Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
NC1199860001Medicare NSC