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General NPI Number Information
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NPI Number | 1447203781
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Entity Type | Individual
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Provider Name | DONALD P HUMPHREY O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 407 N PLANT AVE
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City | PLANT CITY
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State | FL
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Zip | 33563-7247
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Country | US
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Telephone | 813-754-4558
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Fax | 813-752-1789
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Provider Business Mailing Address
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Address Line | 407 N PLANT AVE
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City | PLANT CITY
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State | FL
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Zip | 33563-7247
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Country | US
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Telephone | 813-754-4558
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Fax | 813-752-1789
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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 | OPC 1158
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License Number State | FL
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