Provider Demographics
NPI:1679092498
Name:GILMOUR, EILEEN MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:MARIE
Last Name:GILMOUR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 S TWIN OAKS VALLEY RD
Mailing Address - Street 2:APT 296
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-7328
Mailing Address - Country:US
Mailing Address - Phone:206-708-9489
Mailing Address - Fax:
Practice Address - Street 1:5619 CAROLINA BEACH RD STE 110
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-2814
Practice Address - Country:US
Practice Address - Phone:910-790-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2492152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist