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NPI Code Detail

MEDICARE: DR. JASON T. MCCAIN O.D. P.C.

MEDICARE: DR. JASON T. MCCAIN O.D. P.C.
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
1152W00000XOptometrist4952/T1822OH

General Provider Information

NPI Number : 1033440870
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. JASON T. MCCAIN O.D. P.C.
Provider Business Mailing Address
First Line : 6244 WILMINGTON PIKE
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-7024
Country : US
Telephone Number : 937-848-2243
Fax Number : 937-848-2498
Provider Business Practice Location Address
First Line : 6244 WILMINGTON PIKE
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-7024
Country : US
Telephone Number : 937-848-2243
Fax Number : 937-848-2498
Authorized Official
Title or Position : PRESIDENT
Name : DR. JASON TYLER MCCAIN
Credential : O.D.
Telephone Number : 937-848-2243
Provider Enumeration Date : 01/19/2010
Last Update Date : 01/19/2010

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