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General NPI Number Information
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NPI Number | 1215988027
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Entity Type | Individual
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Provider Name | MICHAEL J OMEARA OD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 225 W ASHLAND AVE SUITE 1
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City | INDIANOLA
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State | IA
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Zip | 50125-2462
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Country | US
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Telephone | 515-961-5305
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Fax | 515-961-9225
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Provider Business Mailing Address
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Address Line | 225 W ASHLAND AVE SUITE 1
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City | INDIANOLA
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State | IA
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Zip | 50125-2462
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Country | US
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Telephone | 515-961-5305
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Fax | 515-961-9225
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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 | 1920
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License Number State | IA
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