Provider Demographics
NPI:1649298548
Name:ONSLOW OPHTHALMOLOGY, PA
Entity type:Organization
Organization Name:ONSLOW OPHTHALMOLOGY, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-355-3937
Mailing Address - Street 1:6 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7325
Mailing Address - Country:US
Mailing Address - Phone:910-355-3937
Mailing Address - Fax:910-347-6663
Practice Address - Street 1:6 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7325
Practice Address - Country:US
Practice Address - Phone:910-355-3937
Practice Address - Fax:910-347-6663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0233BOtherBCBS OF NC
NC890233BMedicaid
1314390001Medicare NSC
NC0233BOtherBCBS OF NC