Provider Demographics
NPI:1871741157
Name:GLASS, AARON BISHOP (OD)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:BISHOP
Last Name:GLASS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-8968
Mailing Address - Country:US
Mailing Address - Phone:919-639-2020
Mailing Address - Fax:919-639-8508
Practice Address - Street 1:104 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-8968
Practice Address - Country:US
Practice Address - Phone:919-639-2020
Practice Address - Fax:919-639-8508
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2113152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy