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General NPI Number Information
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NPI Number | 1144372103
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Entity Type | Organization
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Legal Business Name | AURORA VISION GROUP, P.C.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 2567 HOUSLEY RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-6751
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Country | US
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Telephone | 410-224-2306
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Fax | 410-224-0206
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Provider Business Mailing Address
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Address Line | 2567 HOUSLEY RD
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City | ANNAPOLIS
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State | MD
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Zip | 21401-6751
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Country | US
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Telephone | 410-224-2306
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Fax | 410-224-0206
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN T. BARR
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Credential | O.D.
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Telephone | 410-224-2306
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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 | TA-1003
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License Number State | MD
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