=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043289382
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD KEITH MCFEE O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2006
-----------------------------------------------------
Last Update Date | 12/21/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1714 WASHINGTON BLVD
-----------------------------------------------------
City | BELPRE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45714-2096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-423-9521
-----------------------------------------------------
Fax | 740-423-6882
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1714 WASHINGTON BLVD
-----------------------------------------------------
City | BELPRE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45714-2096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-423-9521
-----------------------------------------------------
Fax | 740-423-6882
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 5404
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------