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NPI Code Detail

MEDICARE: DR. JAMES KUNDART

MEDICARE: DR. JAMES KUNDART
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
1152WV0400XVision Therapy Optometrist3143TOR

General Provider Information

NPI Number : 1710923941
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES KUNDART
Provider Business Mailing Address
First Line : PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY
Second Line : 2043 COLLEGE WAY
City : FOREST GROVE
State : OR
Zip : 97116-1797
Country : US
Telephone Number : 503-352-2020
Fax Number : 503-352-2929
Provider Business Practice Location Address
First Line : PACIFIC UNIVERSITY COLLEGE OF OPTOMETRY
Second Line : 2043 COLLEGE WAY
City : FOREST GROVE
State : OR
Zip : 97116-1797
Country : US
Telephone Number : 503-352-2020
Fax Number : 503-352-2929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 07/09/2007

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