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General NPI Number Information
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NPI Number | 1386804292
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Entity Type | Organization
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Legal Business Name | DR BRIAN ATKINS AND ASSOCIATES LTD
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 2765 VETERANS PKWY
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City | SPRINGFIELD
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State | IL
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Zip | 62704-6402
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Country | US
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Telephone | 217-787-6276
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Fax | 217-787-6245
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Provider Business Mailing Address
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Address Line | 2765 VETERANS PKWY
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City | SPRINGFIELD
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State | IL
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Zip | 62704-6402
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Country | US
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Telephone | 217-787-6276
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Fax | 217-787-6245
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN DOUGLAS ATKINS
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Credential | OD
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Telephone | 217-787-6276
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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 | 468506
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License Number State | IL
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