Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1101 | NC |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 1101 | NC |
NPI | 1255319109 |
---|---|
Provider Name | Dr. William Michael Jamison |
First Address | Charlotte, NC 28217-4116 |
Second Address | Charlotte, NC 28217-4116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2006 |
Last Update Date | 03/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09446 | BCBS (01) | NC |
7909446 | (05) | NC |
T64944 | (02) | NC |