MEDICARE: DR. DAVID P ALAN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG000488	PA

General Provider Information

NPI Number	:	1225012073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID P ALAN OD

Provider Business Mailing Address
First Line	:	203 NORTH REDWOOD STREET
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461
Country	:	US
Telephone Number	:	724-583-7793
Fax Number	:	724-583-9515

Provider Business Practice Location Address
First Line	:	203 N REDWOOD ST
Second Line	:
City	:	MASONTOWN
State	:	PA
Zip	:	15461-1668
Country	:	US
Telephone Number	:	724-583-7793
Fax Number	:	724-583-9515

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	12/02/2013

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Directions to “ DR. DAVID P ALAN OD” Practice Location

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