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NPI Code Detail

MEDICARE: DR. DAVID LYNN DOSS O.D.

MEDICARE: DR. DAVID LYNN DOSS 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
1152W00000XOptometristT03481MO
2152W00000XOptometrist2299OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598751778
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID LYNN DOSS O.D.
Provider Business Mailing Address
First Line : PO BOX 160
Second Line :
City : SHIPROCK
State : NM
Zip : 87420-0160
Country : US
Telephone Number : 505-368-6001
Fax Number : 505-368-6431
Provider Business Practice Location Address
First Line : 6 ROAD 7586
Second Line :
City : BLOOMFIELD
State : NM
Zip : 87413-4934
Country : US
Telephone Number : 580-421-4570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 12/27/2017

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