| NPI | 1023632270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DAX HAWKINS Medical Director 910-796-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2020-07-16 |