MEDICARE: DR. MEAGAN M HERRING O.D., F.A.A,O.

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	0618002024	VA
2	152W00000X	Optometrist	34159	CA
3	152W00000X	Optometrist	OPC4716	FL

General Provider Information

NPI Number	:	1912293382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEAGAN M HERRING O.D., F.A.A,O.

Provider Business Mailing Address
First Line	:	6809 FIVE STAR BLVD
Second Line	:	STE 100A
City	:	ROCKLIN
State	:	CA
Zip	:	95677-2687
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	41272 US HIGHWAY 19 N
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-5106
Country	:	US
Telephone Number	:	727-937-6551
Fax Number	:

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

Provider Enumeration Date	:	06/23/2011
Last Update Date	:	08/31/2020

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