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NPI Code Detail

MEDICARE: MARK EAVES OD

MEDICARE: MARK EAVES 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
1152WC0802XCorneal and Contact Management OptometristOPC6621FL
2152W00000XOptometristOPT003592GA

General Provider Information

NPI Number : 1518702562
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK EAVES OD
Provider Business Mailing Address
First Line : PO BOX 11407
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35246-8575
Country : US
Telephone Number : 864-359-1308
Fax Number : 239-496-3939
Provider Business Practice Location Address
First Line : 4101 EVANS AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9310
Country : US
Telephone Number : 239-939-3456
Fax Number : 239-335-1782
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2024
Last Update Date : 04/14/2026

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Directions to “ MARK EAVES OD” Practice Location

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