MEDICARE: JAMES WILLIAM ANDREWS 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	OPC001391	FL
2	152WC0802X	Corneal and Contact Management Optometrist	OPC001391	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1043497209	OTHER		ORGANIZATIONAL NPI

General Provider Information

NPI Number	:	1265425755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES WILLIAM ANDREWS OD

Provider Business Mailing Address
First Line	:	5062 MOBILE HWY
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32506-3240
Country	:	US
Telephone Number	:	850-453-4373
Fax Number	:	850-453-1953

Provider Business Practice Location Address
First Line	:	5062 MOBILE HWY
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32506-3240
Country	:	US
Telephone Number	:	850-453-4373
Fax Number	:	850-453-1953

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	08/27/2020

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