Cavalier Optometry Clinic LTD

Organization Active NPI Optometrist · Cavalier, ND

NPI 1730173238 · NPPES record last updated Nov 2, 2007

Key facts

NPI
1730173238
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
358 (ND)
Legal business name
CAVALIER OPTOMETRY CLINIC LTD
Practice address
201 E 3Rd Ave S
Cavalier, ND 58220
Phone
(701) 265-8315
Fax
(701) 265-8317
NPI assigned
Sep 12, 2005
Organization subpart
No

Authorized official

Name
Dr. S Meredith Clark, O.D.
Title
President
Phone
(701) 265-8315

National Provider Directory

Locations

201 E 3rd Ave S
#148
Cavalier, ND 58220
Phone (701) 265-8315

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X 358 ND Yes

Addresses

Primary practice location

201 E 3Rd Ave S
Cavalier, ND 58220

Mailing address

PO Box 148
Cavalier, ND 58220-0148
Phone (701) 265-8315

Other identifiers

IdentifierTypeStateIssuer
0677790001OtherNDCIGNA
140622OtherNDUCARE MINN
979611041243OtherNDPREFERRED ONE
CLA800358OtherNDVISION SERVICES INC
60162MedicaidND
91398OtherNDEYES FOR NEEDY
93094CAOtherNDBLUE CROSS MINNESOTA

Other providers in Cavalier, ND

All providers in Cavalier, ND · Optometrist in North Dakota

Sources for this page

Verify at the official NPI Registry.