Provider Demographics
NPI:1932417318
Name:YORK, BECKY CALL (OD)
Entity Type:Individual
Prefix:DR
First Name:BECKY
Middle Name:CALL
Last Name:YORK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:BECKY
Other - Middle Name:ELAINE
Other - Last Name:CALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:108 THORA DR
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-9594
Mailing Address - Country:US
Mailing Address - Phone:336-391-3521
Mailing Address - Fax:
Practice Address - Street 1:801 E CENTER ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4401
Practice Address - Country:US
Practice Address - Phone:336-249-8901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-19
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2189152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5915839Medicaid
NC2484654Medicare PIN
NC2484654AMedicare PIN