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General NPI Number Information
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NPI Number | 1851479737
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Entity Type | Organization
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Legal Business Name | NORTHWEST EYE ASSOCIATES PC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 1709 MAIN ST
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City | WOODWARD
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State | OK
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Zip | 73801-2938
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Country | US
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Telephone | 580-256-7755
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Fax | 580-256-4819
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Provider Business Mailing Address
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Address Line | PO BOX 1128
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City | WOODWARD
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State | OK
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Zip | 73802-1128
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Country | US
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Telephone | 580-256-7755
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Fax | 580-256-4819
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID C JONES
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Credential | O.D.
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Telephone | 580-256-7755
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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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