Andrew Jackson Etheridge IV
Ocularist Orthotic Fitter
2613 Carver St
Durham
, North Carolina 27705-2720
Andrew Jackson Etheridge IV
Ocularist Orthotic Fitter
2613 Carver St
Durham
, North Carolina 27705-2720
(252) 230-4785
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About
Features
Specialties
- Ocularist
- Orthotic Fitter
Languages spoken
- English
Location
First Address
- Andrew Jackson Etheridge IV
- 812 Woodgreen Dr
- Durham, NC
- Zip : 27704-6032
- Phone : (252) 230-4785
Second Address
- Andrew Jackson Etheridge IV
- 2613 Carver St
- Durham, NC
- Zip : 27705-2720
- Phone : (919) 383-1205
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 156FX1700X | Ocularist | ||
| N | 225000000X | Orthotic Fitter |
National Provider Identifier
| NPI | 1487246369 |
|---|---|
| Provider Name | Andrew Jackson Etheridge IV |
| First Address | Durham, NC 27704-6032 |
| Second Address | Durham, NC 27705-2720 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/02/2021 |
| Last Update Date | 11/02/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.