Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | S398TA100 | AL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | S398TA100 | AL |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | S398TA100 | AL |
N | 152WP0200X | Pediatric Optomitrist | S398TA100 | AL |
N | 152WS0006X | Sports Vision | S398TA100 | AL |
N | 152WX0102X | Occupational Vision | S398TA100 | AL |
NPI | 1295875078 |
---|---|
Provider Name | Dr. Barry J. Mcnamara |
First Address | Prattville, AL 36066-3661 |
Second Address | Prattville, AL 36066-3661 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 02/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
51058560 | BLUE CROSS BLUE SHIELD (01) | AL |
529401860 | (05) | AL |
T68993 | (02) | AL |