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General NPI Number Information
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NPI Number | 1174585301
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Entity Type | Individual
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Provider Name | PAULA HARMON BOONE OD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | BLD. 277 OPTOMETRY DEPARTMENT NORFOLK NAVAL SHIPYARD BRANCH HEALTH CLINIC
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City | PORTSMOUTH
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State | VA
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Zip | 23709-5000
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Country | US
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Telephone | 757-953-6490
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Fax |
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Provider Business Mailing Address
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Address Line | 674 FERNWOOD FARMS RD
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City | CHESAPEAKE
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State | VA
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Zip | 23320-6765
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Country | US
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Telephone | 757-547-4137
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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 | 0618000487
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License Number State | VA
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