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General NPI Number Information
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NPI Number | 1245611268
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Entity Type | Organization
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Legal Business Name | PANHANDLE CATARACT AND LASER INSTITUTE LLC
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 5101 N. DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32503-2040
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Country | US
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Telephone | 850-438-1277
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Fax | 850-438-1278
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Provider Business Mailing Address
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Address Line | 5101 N. DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32503-2040
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Country | US
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Telephone | 850-438-1277
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Fax | 850-438-1278
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARL H SPEAR
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Credential | OD
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Telephone | 850-438-1277
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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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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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