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NPI Code Detail

MEDICARE: DR. PATRICK DEE STARRETT OD

MEDICARE: DR. PATRICK DEE STARRETT 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
1152W00000XOptometrist1464GA

General Provider Information

NPI Number : 1407855109
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK DEE STARRETT OD
Provider Business Mailing Address
First Line : 1061 HARMON AVE
Second Line : USAMEDDAC
City : FORT STEWART
State : GA
Zip : 31314-5641
Country : US
Telephone Number : 912-435-5948
Fax Number : 912-435-5950
Provider Business Practice Location Address
First Line : 1061 HARMON AVE
Second Line : USAMEDDAC
City : FORT STEWART
State : GA
Zip : 31314-5641
Country : US
Telephone Number : 912-435-5948
Fax Number : 912-435-5950
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2005
Last Update Date : 10/07/2010

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