Provider Demographics
NPI:1831373778
Name:THE FOCUS GROUP OPTOMETRIC ASSOCIATES PA
Entity type:Organization
Organization Name:THE FOCUS GROUP OPTOMETRIC ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:HOOPER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:828-884-4455
Mailing Address - Street 1:840 FLEMING ST
Mailing Address - Street 2:STE 4
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-3513
Mailing Address - Country:US
Mailing Address - Phone:828-697-9909
Mailing Address - Fax:828-697-6553
Practice Address - Street 1:840 FLEMING ST
Practice Address - Street 2:STE 4
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3513
Practice Address - Country:US
Practice Address - Phone:828-697-9909
Practice Address - Fax:828-697-6553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1275152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89093HAMedicaid
0996HOtherBLUE CROSS BLUE SHIELD NC
410041992Medicare PIN
2471903Medicare PIN
0996HOtherBLUE CROSS BLUE SHIELD NC
T65063Medicare UPIN