MEDICARE: MCWILLIAMS VISION CARE LLC

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	:	1477811040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCWILLIAMS VISION CARE LLC

Provider Business Mailing Address
First Line	:	7144 E VIRGINIA ST STE A
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-9125
Country	:	US
Telephone Number	:	812-473-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	7144 E VIRGINIA ST STE A
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-9125
Country	:	US
Telephone Number	:	812-473-6080
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	BRITTNEY MCWILLIAMS
Credential	:	OD
Telephone Number	:	812-473-6080

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	04/14/2016

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