MEDICARE: WEST POINT OPTICAL GROUP

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

General Provider Information

NPI Number	:	1831823731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST POINT OPTICAL GROUP

Provider Business Mailing Address
First Line	:	PO BOX 631665
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-1665
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 HAZELTON RD
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55435-4204
Country	:	US
Telephone Number	:	952-926-6149
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	SARAH DOWLING
Credential	:
Telephone Number	:	614-761-1255

Provider Enumeration Date	:	07/15/2022
Last Update Date	:	04/09/2024

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Directions to “WEST POINT OPTICAL GROUP ” Practice Location

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