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General NPI Number Information
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NPI Number | 1598451825
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Entity Type | Organization
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Legal Business Name | EYCON LLC
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 1100 2ND PL SE APT 200
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City | WASHINGTON
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State | DC
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Zip | 20003-2556
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Country | US
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Telephone | 814-241-9413
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 2ND PL SE APT 200
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City | WASHINGTON
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State | DC
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Zip | 20003-2556
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Country | US
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Telephone | 814-241-9413
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Fax |
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Authorized Official
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Title or Position | OD/PRSIDENT
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Name | DR. NATHANIEL MCKAY
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Credential | OD
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Telephone | 814-241-9413
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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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