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General NPI Number Information
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NPI Number | 1831340330
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Entity Type | Organization
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Legal Business Name | DAVID F. MERRITT, O.D.
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Dates
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Enumeration Date | 10/02/2008
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Last Update Date | 03/08/2010
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Provider Practice Location Address
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Address Line | 130 S MAIN ST
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City | SPARTA
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State | TN
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Zip | 38583-2215
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Country | US
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Telephone | 931-836-2424
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Fax | 931-836-1314
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Provider Business Mailing Address
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Address Line | 130 S MAIN ST
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City | SPARTA
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State | TN
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Zip | 38583-2215
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Country | US
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Telephone | 931-836-2424
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Fax | 931-836-1314
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID F. MERRITT
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Credential | O.D.
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Telephone | 931-836-2424
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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 | ODT-1636
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License Number State | TN
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