Basic Information
| Provider Information | |||||||||
| NPI: | 1467415885 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BINKLEY | ||||||||
| FirstName: | DUANE | ||||||||
| MiddleName: | KEITH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW BERN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285625211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2526332901 | ||||||||
| FaxNumber: | 2526332037 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 MARTIN LUTHER KING JR BLVD | ||||||||
| Address2: | |||||||||
| City: | NEW BERN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 285625211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2526332901 | ||||||||
| FaxNumber: | 2526332037 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 01/02/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1536 | NC | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 890907T | 05 | NC | MEDICAID | 0907T | 01 | NC | BCBS PROV # | OTHER |