Provider Demographics
NPI:1083232854
Name:ALBEMARLE EYE CENTER, PLLC
Entity type:Organization
Organization Name:ALBEMARLE EYE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-964-8532
Mailing Address - Street 1:1503 N ROAD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3243
Mailing Address - Country:US
Mailing Address - Phone:252-335-5446
Mailing Address - Fax:252-335-4153
Practice Address - Street 1:560 KEMPSVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3603
Practice Address - Country:US
Practice Address - Phone:252-335-5446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBEMARLE EYE CENTER, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-08
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty