MEDICARE: WEST POINT OPTICAL GROUP

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

General Provider Information

NPI Number	:	1447793898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST POINT OPTICAL GROUP

Provider Business Mailing Address
First Line	:	1595 GEORGESVILLE SQUARE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3689
Country	:	US
Telephone Number	:	904-545-4465
Fax Number	:

Provider Business Practice Location Address
First Line	:	1595 GEORGESVILLE SQUARE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228-3689
Country	:	US
Telephone Number	:	904-545-4465
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	RYAN WILLIAMS
Credential	:
Telephone Number	:	904-545-4465

Provider Enumeration Date	:	12/02/2016
Last Update Date	:	12/02/2016

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Directions to “WEST POINT OPTICAL GROUP ” Practice Location

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