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General NPI Number Information
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NPI Number | 1538391560
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Entity Type | Organization
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Legal Business Name | I STUART MCIVER OD PLLC
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Dates
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Enumeration Date | 08/08/2009
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Last Update Date | 08/03/2010
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Provider Practice Location Address
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Address Line | 611 S 13TH ST
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City | FORT PIERCE
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State | FL
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Zip | 34950-4054
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Country | US
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Telephone | 954-232-9585
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Fax | 954-433-5770
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Provider Business Mailing Address
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Address Line | 1206 MEADOWS BLVD
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City | WESTON
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State | FL
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Zip | 33327-1800
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Country | US
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Telephone | 954-232-9585
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Fax | 954-433-5770
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IAIN STUART MCIVER
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Credential | O.D.
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Telephone | 954-232-9585
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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 | OPC2728
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License Number State | FL
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