Healthcare Provider Details

I. General information

NPI: 1457524597
Provider Name (Legal Business Name): BARRY J MCNAMARA OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 JASMINE TRL
PRATTVILLE AL
36066-3661
US

IV. Provider business mailing address

605 JASMINE TRL
PRATTVILLE AL
36066-3661
US

V. Phone/Fax

Practice location:
  • Phone: 334-365-2020
  • Fax: 334-365-4845
Mailing address:
  • Phone: 334-365-2020
  • Fax: 334-365-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberS398TA100
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberS398TA100
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberS398TA100
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License NumberS398TA100
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberS398TA100
License Number StateAL
# 6
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberS398TA100
License Number StateAL

VIII. Authorized Official

Name: MRS. ELIZABETH PRICE
Title or Position: FINANCIAL COORDINATOR
Credential:
Phone: 334-365-2020