MEDICARE: ELIZABETH ANNE TUNALL OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG003931	PA

General Provider Information

NPI Number	:	1003540295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANNE TUNALL OD

Provider Business Mailing Address
First Line	:	758 4TH ST
Second Line	:
City	:	OAKMONT
State	:	PA
Zip	:	15139-1530
Country	:	US
Telephone Number	:	814-331-5707
Fax Number	:

Provider Business Practice Location Address
First Line	:	6501 MARS RD
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5109
Country	:	US
Telephone Number	:	724-553-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2022
Last Update Date	:	06/27/2023

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