MEDICARE: DR. EILEEN CATHERINE MCGILL 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
1	152W00000X	Optometrist	0618000672	VA
2	152W00000X	Optometrist	1023	SC

General Provider Information

NPI Number	:	1790953594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EILEEN CATHERINE MCGILL OD

Provider Business Mailing Address
First Line	:	3840 HOUNDSTOOTH COURT
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-7678
Country	:	US
Telephone Number	:	804-360-9171
Fax Number	:

Provider Business Practice Location Address
First Line	:	11591C WEST BROAD STREET
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-7678
Country	:	US
Telephone Number	:	804-364-0823
Fax Number	:	804-364-8943

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	02/14/2008

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