Provider Demographics
NPI:1063538668
Name:ADLER EYE ASSOCIATES, O.D., P.A.
Entity type:Organization
Organization Name:ADLER EYE ASSOCIATES, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WYCOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-929-7111
Mailing Address - Street 1:861 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7076
Mailing Address - Country:US
Mailing Address - Phone:919-992-9711
Mailing Address - Fax:
Practice Address - Street 1:861 WILLOW DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7076
Practice Address - Country:US
Practice Address - Phone:919-992-9711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0808152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC790915NMedicaid
NC890902HMedicaid
NC8909012Medicaid
NC8909012Medicaid
NCT65118Medicare UPIN
NC2471242BMedicare ID - Type UnspecifiedMATT VIZITHUM
NCT64735Medicare UPIN
NC246178CMedicare ID - Type UnspecifiedBARRY ADLER
NC790915NMedicaid