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General NPI Number Information
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NPI Number | 1629130810
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Entity Type | Organization
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Legal Business Name | DRS WHITTINGTON & WHITTINGTON PTR
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 02/01/2013
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Provider Practice Location Address
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Address Line | 3840 PENNSYLVANIA AVE
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City | CHARLESTON
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State | WV
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Zip | 25302-4650
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Country | US
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Telephone | 304-342-0660
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Fax | 304-344-5483
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Provider Business Mailing Address
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Address Line | 3840 PENNSYLVANIA AVE
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City | CHARLESTON
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State | WV
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Zip | 25302-4650
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Country | US
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Telephone | 304-342-0660
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Fax | 304-344-5483
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JEFFERY LEE WHITTINGTON
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Credential | OD
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Telephone | 304-342-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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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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