Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC001391 | FL |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPC001391 | FL |
NPI | 1265425755 |
---|---|
Provider Name | James William Andrews |
First Address | Pensacola, FL 32506-3240 |
Second Address | Pensacola, FL 32506-3240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 27/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1043497209 | ORGANIZATIONAL NPI (01) | |
T93874 | (02) | FL |