MICHAEL J ENNIS

Dr MICHAEL J ENNIS is a male medical professional, specializing in Optometry. He graduated in 1986 from Southern College Of Optometry.

Contact

131 GLENSFORD DR
SUITE 105
FAYETTEVILLE
NC
283142365

Tel: 9108602020

MICHAEL J ENNIS Information

Npi 1336229186
Pac Id 0244367795
Professional Enrollment Id I20100415000181
Last Name ENNIS
First Name MICHAEL
Middle Name J
Suffix
Gender M
Credential
Medical School Name SOUTHERN COLLEGE OF OPTOMETRY
Graduation Year 1986
Primary Specialty OPTOMETRY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
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Organization Legal Name
Group Practice Pac Id
Number Of Group Practice Members
Line 1 Street Address 131 GLENSFORD DR
Line 2 Street Address SUITE 105
Marker Of Address Line 2 Suppression
City FAYETTEVILLE
State NC
Zip Code 283142365
Phone Number 9108602020
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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