| Vision International Pa | |
|
2047 Valleygate Dr, Fayetteville, NC 28304-3688 | |
| (910) 485-3937 | |
| (910) 221-3672 |
| Full Name | Vision International Pa |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 2047 Valleygate Dr, Fayetteville, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942378187 | NPI | - | NPPES |
| 89016ME | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Michael G Woodcock |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871521625 PECOS PAC ID: 2769458140 Enrollment ID: I20040910000393 |
| Provider Name | Keith Lyndon Mccormick |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1912970815 PECOS PAC ID: 6800998915 Enrollment ID: I20070220000652 |
| Provider Name | Renzo A Zaldivar |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548234313 PECOS PAC ID: 4789657859 Enrollment ID: I20090720000213 |
| Provider Name | Ray M Freeman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1962504514 PECOS PAC ID: 1052318201 Enrollment ID: I20210903001609 |
| Provider Name | David Josip Grasic |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1982256558 PECOS PAC ID: 9436548781 Enrollment ID: I20211108002932 |
| Provider Name | Nicholas Alexander Rougraff |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1598342305 PECOS PAC ID: 3678082559 Enrollment ID: I20250603000027 |
| Mailing Address | Practice Location Address |
|---|---|
| Vision International Pa 2047 Valleygate Dr, Fayetteville, NC 28304-3688 Ph: (910) 485-3937 | Vision International Pa 2047 Valleygate Dr, Fayetteville, NC 28304-3688 Ph: (910) 485-3937 |