Shannon L Clark O D P A in Fort Pierce - Eyewear Supplier
Shannon L Clark O D P A - NPI 1770767733
Shannon L Clark O D P A is a Eyewear Supplier in Fort Pierce, Florida. Shannon L Clark O D P A practices all healthcare services and medical treatments related to Eyewear Supplier. The NPI Number for Shannon L Clark O D P A is 1770767733. The last update date is 2008-07-29.
Shannon L Clark O D P A's current location address is 2305 Oleander Blvd, Fort Pierce, Florida. You can contact this provider via phone number 7724656616. The mailing address for Shannon L Clark O D P A is 2305 Oleander Blvd, Fort Pierce, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Shannon L Clark O D P A |
|---|---|
| Address | 2305 Oleander Blvd, Fort Pierce, Florida |
| Phone Number | 7724656616 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT/ |
|---|---|
| Authorized Official Name | Clark Leitenbauer L W Shannon |
| Credentials | O.D. |
| Telephone Number | 7724656616 |
NPI Number Detail
| NPI Number | 1770767733 |
|---|---|
| Provider Enumeration Date | 2007-12-26 |
| Last Updated Date | 2008-07-29 |
Provider Mailing Address Detail
| Address | 2305 Oleander Blvd |
|---|---|
| City | Fort Pierce |
| State | Florida (FL) |
| Post Code | 349825830 |
| Phone Number | 7724656616 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Eyewear Supplier |
|---|---|
| Taxonomy | 332H00000X |
| Licence No | OPC 0003067 |
|
Definition: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Shannon L Clark O D P A by the Centers for Medicare & Medicaid Services?
The Shannon L Clark O D P A has been issued the NPI (National Provider Identifier) 1770767733, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Shannon L Clark O D P A's physical address?
The Shannon L Clark O D P A is physically located at 2305 Oleander Blvd, in the city of Fort Pierce, FL, with the postal code 349825830.
What is Shannon L Clark O D P A's area of expertise and its corresponding taxonomy classification?
The Shannon L Clark O D P A's field of specialization is Eyewear Supplier, and it falls under the taxonomy code 332H00000X, which categorizes healthcare providers based on their areas of practice.
When did Shannon L Clark O D P A receive its 1770767733 assignment?
The Shannon L Clark O D P A was assigned its 1770767733 on 2007-12-26, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Shannon L Clark O D P A, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Shannon L Clark O D P A, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2008-07-29.
NPI Number: 1588667679
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