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NPI Code Detail

MEDICARE: DR. JAMES D. EGBERT, OPTOMETRIST, INC.

MEDICARE: DR. JAMES D. EGBERT, OPTOMETRIST, INC.
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1841321809
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. JAMES D. EGBERT, OPTOMETRIST, INC.
Provider Business Mailing Address
First Line : 6557 BRANDT PK
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424
Country : US
Telephone Number : 937-236-1770
Fax Number :
Provider Business Practice Location Address
First Line : 6557 BRANDT PIKE
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-3353
Country : US
Telephone Number : 937-236-1770
Fax Number :
Authorized Official
Title or Position : INSURANCE COORDINATOR
Name : MS. JANET A YEAZEL
Credential :
Telephone Number : 937-236-1770
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/10/2008

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Directions to “DR. JAMES D. EGBERT, OPTOMETRIST, INC. ” Practice Location

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