Provider Demographics
NPI: | 1588747828 |
---|---|
Name: | DR. ROBERT M CURRIN OD,PA |
Entity type: | Organization |
Organization Name: | DR. ROBERT M CURRIN OD,PA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OPTOMETRIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CURRIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 919-693-1133 |
Mailing Address - Street 1: | 4172 INDIAN TRAIL RD |
Mailing Address - Street 2: | |
Mailing Address - City: | OXFORD |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 27565-7596 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 919-693-1785 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1555 LAKE RD HWY 56 |
Practice Address - Street 2: | SUITE 5-B |
Practice Address - City: | CREEDMOOR |
Practice Address - State: | NC |
Practice Address - Zip Code: | 27522 |
Practice Address - Country: | US |
Practice Address - Phone: | 919-528-3781 |
Practice Address - Fax: | 919-528-0000 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-23 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | 1149 | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |