MEDICARE: DR. STEVEN L. FOLLANSBEE 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	OEG000076	PA

General Provider Information

NPI Number	:	1346245123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN L. FOLLANSBEE O.D.

Provider Business Mailing Address
First Line	:	123 VILLAGE CENTER DRIVE
Second Line	:	SUITE 11
City	:	LORDS VALLEY
State	:	PA
Zip	:	18428-9098
Country	:	US
Telephone Number	:	570-775-7675
Fax Number	:	570-775-7974

Provider Business Practice Location Address
First Line	:	123 VILLAGE CENTER DR
Second Line	:	SUITE 11
City	:	LORDS VALLEY
State	:	PA
Zip	:	18428-6134
Country	:	US
Telephone Number	:	570-775-7675
Fax Number	:	570-775-7974

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	03/14/2013

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