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General NPI Number Information
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NPI Number | 1184728776
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Entity Type | Organization
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Legal Business Name | DR. DOUGLAS D. AYRE, OPTOMETRIST, PA
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 713 MCKINLEY
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City | GREAT BEND
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State | KS
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Zip | 67530
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Country | US
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Telephone | 620-792-3535
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Fax | 620-792-3534
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Provider Business Mailing Address
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Address Line | 713 MCKINLEY
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City | GREAT BEND
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State | KS
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Zip | 67530
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Country | US
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Telephone | 620-792-3535
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Fax | 620-792-3534
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS DUANE AYRE
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Credential |
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Telephone | 620-285-2105
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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 |
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License Number State |
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