Provider Demographics
NPI:1295834182
Name:MCCONARTY, WILLIAM P (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:MCCONARTY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 ROXBURY DR
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4038
Mailing Address - Country:US
Mailing Address - Phone:240-418-7146
Mailing Address - Fax:
Practice Address - Street 1:9812 FALLS RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3976
Practice Address - Country:US
Practice Address - Phone:301-299-6513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1689152W00000X
VA0618001285152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist