Provider Demographics
NPI:1043497209
Name:JAMES WILLIAM ANDREWS, OD
Entity Type:Organization
Organization Name:JAMES WILLIAM ANDREWS, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:850-453-4373
Mailing Address - Street 1:5062 MOBILE HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-3240
Mailing Address - Country:US
Mailing Address - Phone:850-453-4373
Mailing Address - Fax:850-453-1953
Practice Address - Street 1:5062 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-3240
Practice Address - Country:US
Practice Address - Phone:850-453-4373
Practice Address - Fax:850-453-1953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-29
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1391152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1265425755OtherNPI
FLT93874Medicare UPIN
1193850001Medicare NSC
FL19282Medicare PIN