Provider Demographics
NPI:1871696740
Name:WESTERN CAROLINA EYE ASSOCIATES, PA
Entity type:Organization
Organization Name:WESTERN CAROLINA EYE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-264-0042
Mailing Address - Street 1:610 STATE FARM RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4738
Mailing Address - Country:US
Mailing Address - Phone:828-264-0042
Mailing Address - Fax:828-264-8612
Practice Address - Street 1:257 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28640-9561
Practice Address - Country:US
Practice Address - Phone:336-246-3937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1704152W00000X
NC31161207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty