Healthcare Provider Details

I. General information

NPI: 1043497209
Provider Name (Legal Business Name): JAMES WILLIAM ANDREWS, OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 08/27/2020
Certification Date: 08/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5062 MOBILE HWY
PENSACOLA FL
32506-3240
US

IV. Provider business mailing address

5062 MOBILE HWY
PENSACOLA FL
32506-3240
US

V. Phone/Fax

Practice location:
  • Phone: 850-453-4373
  • Fax: 850-453-1953
Mailing address:
  • Phone: 850-453-4373
  • Fax: 850-453-1953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC1391
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberOPC1391
License Number StateFL

VIII. Authorized Official

Name: DR. JAMES WILLIAM ANDREWS
Title or Position: OWNER
Credential: O.D.
Phone: 850-453-4373