Mt Airy Vision Center

LBN: Dr Michael Clark Optometrist Pa
Mt Airy Vision Center is an health care organization with primary practice located at 602 S Renfro St , Mount Airy NC 27030-4742. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Dr Michael Clark Optometrist Pa can be contacted via phone (336) 789-9031, or through Clark, Michael via phone (336) 789-9031.

Contact Information

Primary practice address
602 S Renfro St Mount Airy NC 27030-4742
Fax: (336) 789-8343
Website:
Authorized official contact:
Name: Clark, Michael Doctor of Optometry (OD)

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0884 North Carolina

Profile Details

NPI number 1407936008
LBN Legal business name Dr Michael Clark Optometrist Pa
DBA Doing business as Mt Airy Vision Center
Authorized official Clark, Michael Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2006
Last updated Mar 21st, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407936008 NPPES
North Carolina MEDICAID 89013MW
North Carolina Other 3739
North Carolina Other 1409898
North Carolina Other 9203311
North Carolina Other 013MW
North Carolina Other 580000014

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