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NPI 1124181177

NPI 1124181177 : DAVID POPE MACKAY O.D. : BEDFORD, NH

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General NPI Number Information
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    NPI Number           |    1124181177
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    Entity Type          |    Individual 
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    Provider Name        |    DAVID POPE MACKAY O.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/19/2006
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    Last Update Date     |    06/12/2008
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Provider Practice Location Address
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    Address Line         |    207 MEETINGHOUSE RD 
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    City                 |    BEDFORD
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    State                |    NH
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    Zip                  |    03110-6090
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    Country              |    US
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    Telephone            |    603-668-2771
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    Fax                  |    603-627-3115
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Provider Business Mailing Address
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    Address Line         |    207 MEETINGHOUSE RD 
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    City                 |    BEDFORD
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    State                |    NH
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    Zip                  |    03110-6090
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    Country              |    US
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    Telephone            |    603-668-2771
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    Fax                  |    603-627-3115
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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       |    0627
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    License Number State |    NH
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Taxonomy #2
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    Taxonomy Code        |    152WC0802X
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    Taxonomy Name        |    Corneal and Contact Management Optometrist
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    License Number       |    0627
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    License Number State |    NH
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Taxonomy #3
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    Taxonomy Code        |    152WS0006X
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    Taxonomy Name        |    Sports Vision Optometrist
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    License Number       |    0627
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    License Number State |    NH
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