Provider Demographics
NPI:1023066040
Name:ROCKINGHAM EYE ASSOCIATES PA
Entity type:Organization
Organization Name:ROCKINGHAM EYE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAINES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:336-627-5271
Mailing Address - Street 1:515 THOMPSON STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5068
Mailing Address - Country:US
Mailing Address - Phone:336-627-5271
Mailing Address - Fax:336-623-5182
Practice Address - Street 1:515 THOMPSON ST
Practice Address - Street 2:SUITE A
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5068
Practice Address - Country:US
Practice Address - Phone:336-627-5271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26004207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890258BMedicaid
NC0258BOtherBCBS
NC890258BMedicaid
NC1652Medicare PIN