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NPI Code Detail

MEDICARE: DR. TODD NEUGENT OD, P.C

MEDICARE: DR. TODD NEUGENT OD, P.C
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
1152W00000XOptometrist401IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NM01P293OTHERNMBCBS

General Provider Information

NPI Number : 1558479196
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD NEUGENT OD, P.C
Provider Business Mailing Address
First Line : 10224 COORS BYPASS NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87114-4398
Country : US
Telephone Number : 505-898-2400
Fax Number : 505-898-2541
Provider Business Practice Location Address
First Line : 10224 COORS BYPASS NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87114-4398
Country : US
Telephone Number : 505-898-2400
Fax Number : 505-898-2541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 07/08/2007

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Directions to “ DR. TODD NEUGENT OD, P.C” Practice Location

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