MEDICARE: DR. BARRY J. MCNAMARA O.D.

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	S398TA100	AL
2	152WC0802X	Corneal and Contact Management Optometrist	S398TA100	AL
3	152WL0500X	Low Vision Rehabilitation Optometrist	S398TA100	AL
4	152WP0200X	Pediatric Optometrist	S398TA100	AL
5	152WS0006X	Sports Vision Optometrist	S398TA100	AL
6	152WX0102X	Occupational Vision Optometrist	S398TA100	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	51058560	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1295875078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY J. MCNAMARA O.D.

Provider Business Mailing Address
First Line	:	605 JASMINE TRL
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-3661
Country	:	US
Telephone Number	:	334-365-2020
Fax Number	:	334-365-4845

Provider Business Practice Location Address
First Line	:	605 JASMINE TRL
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-3661
Country	:	US
Telephone Number	:	334-365-2020
Fax Number	:	334-365-4845

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	11/02/2010

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