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General NPI Number Information
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NPI Number | 1518113190
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Entity Type | Organization
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Legal Business Name | KATIE G MCCREARY, OD, PL
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 501 N NAVY BLVD
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City | PENSACOLA
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State | FL
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Zip | 32507-2011
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Country | US
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Telephone | 850-453-6635
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E GOVERNMENT ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6135
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Country | US
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Telephone | 850-207-2080
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Fax | 850-497-0733
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. KATIE GILBERT SPEAR
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Credential | OD
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Telephone | 850-207-2080
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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 | OPC3920
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License Number State | FL
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