Timothy Edwards O.D.

NPI 1023036696 - Optometrist - 152W00000X

NPI Details
NPI 1023036696
Gender Male
Enumeration Date 07/18/2006
Last Updated 11/16/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
121 N GRAND AVE W
SPRINGFIELD IL, 62702-2562, US
Phone (217) 528-3233
Fax (217) 528-4511
Business Location
121 N GRAND AVE W
SPRINGFIELD IL, 62702-2562, US
Phone (217) 528-3233
Fax (217) 528-4511
Toxanomy
Taxonomy Code 152W00000X
License State Illinois
License Number 0466007549
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According to our database, Dr. Timothy Edwards O.D. NPI is 1023036696, taxonomy code is 152W00000X and license number is 0466007549, license state is located at Illinois. Timothy Edwards O.D. physically located at 121 N Grand Ave W, Springfield IL, 62702-2562. NPI Number Timothy Edwards O.D. has the Individual type.

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1023036696 NPI number is provided on an as is basis without warranty of any kind. 1023036696 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy Edwards O.D. are for informational purposes only.