Provider Demographics
NPI:1447878970
Name:EYE CARE & SURGEONS OF CHARLOTTE, PLLC
Entity type:Organization
Organization Name:EYE CARE & SURGEONS OF CHARLOTTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALATBARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-684-8400
Mailing Address - Street 1:602 S SUTHERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5063
Mailing Address - Country:US
Mailing Address - Phone:704-684-8400
Mailing Address - Fax:980-326-2079
Practice Address - Street 1:602 S SUTHERLAND AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5063
Practice Address - Country:US
Practice Address - Phone:704-684-8400
Practice Address - Fax:980-326-2079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty