DR. LARRY BRENT WILSHIRE (NPI# 1326065848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326065848 |
Entity Type | Individual |
Full Name | DR. LARRY BRENT WILSHIRE |
Other Name | DR. L. BRENT WILSHIRE |
Credential | MD |
Practice Address |
6 Office Park Dr Jacksonville NC 28546-7325 |
Mailing Address |
201 David Pl Jacksonville NC 28540-4546 |
Practice Telephone | 9103553937 |
Practice Fax Number | 9103476663 |
Mailing Telephone | 9103462085 |
Mailing Fax Number | 9103476663 |
Enumeration Date | 2006-07-17 |
Last Update Date | 2007-11-27 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207W00000X | Ophthalmology | 27869 | NC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NC | BLUECROSS BLUESHIELD | 88165 | 01 |
NC | 8988165 | 05 |
Street Address |
6 OFFICE PARK DR |
City | JACKSONVILLE |
State | NC |
Zip Code | 28546-7325 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457548455 | Heath Brian Ergas | Internal Medicine | 6 Office Park Dr, Jacksonville, NC 28546-7325 | 2007-10-03 |
1689768236 | Carol Maruna Smith | Optometrist | 6 Office Park Dr, Jacksonville, NC 28546-7325 | 2006-10-03 |
1649298548 | Onslow Ophthalmology, Pa | Optometrist | 6 Office Park Dr, Jacksonville, NC 28546-7325 | 2006-07-18 |
1033136551 | Carol Ann Johnston | Ophthalmology | 6 Office Park Dr, Jacksonville, NC 28546-7325 | 2006-07-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
Find all providers in zip 28546 |
Taxonomy Code | 207W00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790216729 | Kumar Sambhav | Ophthalmology | 580 W 8th Street, Tower - II, 3rd Floor, Department of Ophthalmology, Jacksonville, FL 32209 | 2017-03-22 |
1306227335 | Sepehr Bahadorani | Ophthalmology | 580 W 8th St Fl Towerii3, Uf College of Medicine - Jacksonville, Jacksonville, FL 32209-6533 | 2015-06-16 |
1467854240 | Mohammed Ali Tawfik Alyouzbaki | Ophthalmology | 6054 Wateredge Drive South, Jacksonville, FL 32211 | 2014-09-23 |
1841580214 | Chad Michael Kaplan | Ophthalmology | 653 West 8th St, Jacksonville, FL 32209 | 2011-04-19 |
1730479650 | Abdallah Mohamed Jeroudi | Ophthalmology | 2639 Oak St, Jacksonville, FL 32204 | 2011-04-12 |
1881915619 | Omar Gayasaddin | Ophthalmology | 7051 Southpoint Pkwy S Fl 3, Jacksonville, FL 32216-8713 | 2010-06-16 |
1952630121 | Ralph Alphonse Sawyer | Ophthalmology | 10061 Lakes End Ct, Jacksonville, FL 32256-4112 | 2009-12-16 |
1326193020 | Midwest Eye Associates, LLC | Ophthalmology | 1122 Veterans Dr, Suite B, Jacksonville, IL 62650-4032 | 2007-01-24 |
1023118379 | Jeffrey Herschel Levenson | Ophthalmology | 751 Oak St Ste 200, Jacksonville, FL 32204-3361 | 2006-09-25 |
1942317680 | Gerard A. Coluccelli | Ophthalmology | 931 Brookwood Rd, Jacksonville, FL 32207-4211 | 2006-08-25 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 28546 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.