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	:	1881064400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST POINT OPTICAL GROUP

Provider Business Mailing Address
First Line	:	3775 EASTON WAY
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 N LAPEER RD
Second Line	:
City	:	LAKE ORION
State	:	MI
Zip	:	48362-1527
Country	:	US
Telephone Number	:	248-814-7011
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BILL NOBLE
Credential	:
Telephone Number	:	614-395-9775

Provider Enumeration Date	:	09/25/2015
Last Update Date	:	09/25/2015

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Directions to “WEST POINT OPTICAL GROUP ” Practice Location

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