Provider Demographics
NPI:1982974614
Name:PARKER FAMILY EYE CARE, OD, PLLC
Entity Type:Organization
Organization Name:PARKER FAMILY EYE CARE, OD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-734-8998
Mailing Address - Street 1:1299 PARKWAY DR STE F
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-3491
Mailing Address - Country:US
Mailing Address - Phone:919-734-8998
Mailing Address - Fax:919-734-8976
Practice Address - Street 1:1299 PARKWAY DR STE F
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-3491
Practice Address - Country:US
Practice Address - Phone:919-734-8998
Practice Address - Fax:919-734-8976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-11
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5908327Medicaid
NC5919629Medicaid
NC5919629Medicaid