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General NPI Number Information
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NPI Number | 1083709489
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Entity Type | Individual
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Provider Name | DONALD JAMES HENDLEY O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9303 MENTOR AVENUE
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City | MENTOR
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State | OH
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Zip | 44060-8407
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Country | US
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Telephone | 440-974-3303
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Fax |
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Provider Business Mailing Address
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Address Line | 7745 DALEFORD DRIVE
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City | MENTOR
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State | OH
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Zip | 44060-8407
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Country | US
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Telephone | 440-255-2194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3803/T1081
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License Number State | OH
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