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NPI Code Detail

MEDICARE: DR. NANCY C STOVALL OD

MEDICARE: DR. NANCY C STOVALL 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
1152W00000XOptometrist18002855IN

General Provider Information

NPI Number : 1275521551
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NANCY C STOVALL OD
Provider Business Mailing Address
First Line : 340 DAVID LIND DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46217-3410
Country : US
Telephone Number : 317-782-3476
Fax Number :
Provider Business Practice Location Address
First Line : 8139 PENDLETON PIKE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46226-4014
Country : US
Telephone Number : 317-898-2020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 03/13/2009

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Directions to “ DR. NANCY C STOVALL OD” Practice Location

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