MEDICARE: DR. EUGENE A DOWD OPTOMETIST

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	150T	WY

General Provider Information

NPI Number	:	1083741888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENE A DOWD OPTOMETIST

Provider Business Mailing Address
First Line	:	435 BROADWAY ST
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-6244
Country	:	US
Telephone Number	:	307-362-3541
Fax Number	:	307-362-1891

Provider Business Practice Location Address
First Line	:	435 BROADWAY ST
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-6244
Country	:	US
Telephone Number	:	307-362-3541
Fax Number	:	307-362-1891

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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