Provider Demographics
NPI:1124320932
Name:NEW MOUNTAIN EYE ASSOCIATES PLLC
Entity type:Organization
Organization Name:NEW MOUNTAIN EYE ASSOCIATES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BIRD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-452-5816
Mailing Address - Street 1:486 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-8026
Mailing Address - Country:US
Mailing Address - Phone:828-452-5816
Mailing Address - Fax:828-452-0373
Practice Address - Street 1:65 PARK ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-4323
Practice Address - Country:US
Practice Address - Phone:828-648-2483
Practice Address - Fax:828-648-4689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0256VOtherBCBS
NC890256VMedicaid
NC1177520001Medicare NSC