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General NPI Number Information
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NPI Number | 1932294386
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Entity Type | Organization
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Legal Business Name | EASTERN SHORE EYE CARE, PC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 118 LOTTIE LN
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City | FAIRHOPE
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State | AL
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Zip | 36532-2995
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Country | US
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Telephone | 251-928-4076
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Fax | 251-928-9461
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Provider Business Mailing Address
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Address Line | 118 LOTTIE LN
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City | FAIRHOPE
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State | AL
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Zip | 36532-2995
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Country | US
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Telephone | 251-928-4076
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Fax | 251-928-9461
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. DUANE MICHAEL SCHROCK
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Credential | O.D.
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Telephone | 251-928-4076
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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 | 2186
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License Number State | AL
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