William Glenn Macdonald, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3359 Issued in OH

Practice address

2079 Rombach Ave.
Wilmington, OH 45177-0910

Phone

(937) 382-4933

Fax

(937) 383-1336

NPI assigned

Jan 10, 2007

Last updated

Aug 23, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1417006123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451770910",
            "telephone_number": "937-382-4933",
            "fax_number": "937-383-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2079 ROMBACH AVE.",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451770910",
            "telephone_number": "937-382-4933",
            "fax_number": "937-383-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "WILLIAM",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Suzanne I Lukacs
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• Mancell Vontrell Lyttle, CDCA
• Carissa C Macella, LPCC
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• Olivia Danielle Mandich, PSYD
• Andrew J Manganaro, MD

• Optometrist in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.