Organization Name: | TODD MCGEORGE O.D. |
NPI Number: | 1215111612 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD MARVIN MCGEORGE (OWNER) |
Mailing Address: | 2131 Cumberland Ave Middlesboro |
State: | KY US |
Postal Code: | 409652830 |
Phone Number: | 6062422278 |
Fax Number: | 6062422270 |
NPI Enumeration Date: | 12/20/2007 |
NPI Last Update Date: | 06/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332H00000X |
License Number: | 1298DT |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
Taxonomy Specialization: | |
Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |