Mitchell Robert Davis, O.D.
Individual provider Active NPI Optometrist · Enola, PA
NPI 1497716088 · NPPES record last updated Apr 14, 2008
Key facts
- NPI
- 1497716088
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OEG000095 (PA)
- Practice address
- 376 E Penn Dr
Enola, PA 17025-2158 - Phone
- (717) 732-2423
- Fax
- (717) 732-6780
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitchell R Davis, O.D. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG000095 | PA | Yes |
Addresses
Primary practice location
376 E Penn Dr
Enola, PA 17025-2158
Mailing address
376 E Penn Dr
Enola, PA 17025-2158
Phone (717) 732-2423
Other providers in Enola, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.