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NPI Code Detail

MEDICARE: DR. DAVID M. NOONAN OD & ASSOCIATES

MEDICARE: DR. DAVID M. NOONAN OD & ASSOCIATES
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
1332H00000XEyewear Supplier1587NC

General Provider Information

NPI Number : 1578706727
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. DAVID M. NOONAN OD & ASSOCIATES
Provider Business Mailing Address
First Line : 169 NORMAN STATION BLVD
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-6396
Country : US
Telephone Number : 704-663-3796
Fax Number : 704-663-4679
Provider Business Practice Location Address
First Line : 169 NORMAN STATION BLVD
Second Line :
City : MOORESVILLE
State : NC
Zip : 28117-6396
Country : US
Telephone Number : 704-663-3796
Fax Number : 704-663-4679
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. DAVID M NOONAN
Credential : OD
Telephone Number : 704-663-3796
Provider Enumeration Date : 04/16/2009
Last Update Date : 04/16/2009

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