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General NPI Number Information
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NPI Number | 1811044951
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Entity Type | Individual
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Provider Name | DAVID M EADS O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 11/22/2013
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Provider Practice Location Address
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Address Line | 177 WASHINGTON DR
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City | SOMERSET
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State | KY
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Zip | 42501-2938
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Country | US
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Telephone | 606-679-0033
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Fax | 606-679-0152
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Provider Business Mailing Address
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Address Line | 177 WASHINGTON DR
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City | SOMERSET
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State | KY
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Zip | 42501-2938
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Country | US
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Telephone | 606-679-0033
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Fax | 606-679-0152
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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 | 1063DT
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License Number State | KY
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