Healthcare Provider Details

I. General information

NPI: 1326218306
Provider Name (Legal Business Name): JAMES W. HERMAN, OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 TEAYS VALLEY RD
HURRICANE WV
25526-9645
US

IV. Provider business mailing address

3709 TEAYS VALLEY RD
HURRICANE WV
25526-9645
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-2533
  • Fax: 304-757-2534
Mailing address:
  • Phone: 304-757-2533
  • Fax: 304-757-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number826-OD
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number826-OD
License Number StateWV

VIII. Authorized Official

Name: DR. JAMES HERMAN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 304-757-2533