Individual provider · NPI-1

Dr. Walter Lovell Bogart III, M.D.

Ophthalmology · Fayetteville, NC

NPI number1922084151
StatusActive
Last updated in NPPESSep 9, 2024

Details

NPI
1922084151
Entity type
Individual (NPI-1)
Name
Dr. Walter Lovell Bogart III
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Dec 20, 2005
Certification date
Sep 9, 2024
Last updated
Sep 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207W00000X Ophthalmology9500839NCYes

Practice location

1726 Metromedical Dr
Fayetteville, NC 28304-3861

Phone 910-484-2284

Mailing address

603 Bimini Twist Cir Ste C
Lexington, SC 29072-6725

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