Basic Information
| Provider Information | |||||||||
| NPI: | 1972817153 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | EMERY WARD OD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 S KINGS DR | ||||||||
| Address2: | SUITE GG | ||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282042932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043343103 | ||||||||
| FaxNumber: | 7043343943 | ||||||||
| Practice Location | |||||||||
| Address1: | 1960 RANDOLPH RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282071129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7043725332 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2010 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | WARD | ||||||||
| AuthorizedOfficialFirstName: | EMERY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7043343103 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 1036 | NC | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.