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NPI Code Detail

MEDICARE: DR. JAMES M FLYNN OD

MEDICARE: DR. JAMES M FLYNN 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
1152W00000XOptometristL532445MI

General Provider Information

NPI Number : 1295754687
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES M FLYNN OD
Provider Business Mailing Address
First Line : 35184 CENTRAL CITY PKWY
Second Line :
City : WESTLAND
State : MI
Zip : 48185-6215
Country : US
Telephone Number : 734-427-5200
Fax Number : 734-427-8136
Provider Business Practice Location Address
First Line : 655 W 13 MILE RD
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-1844
Country : US
Telephone Number : 248-577-3616
Fax Number : 248-307-9509
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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