Provider Demographics
NPI:1376507376
Name:TOWNSEND, JOHN CUNNINGHAM (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CUNNINGHAM
Last Name:TOWNSEND
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 1:3868 WOODVILLE LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4836
Mailing Address - Country:US
Mailing Address - Phone:410-750-6146
Mailing Address - Fax:
Practice Address - Street 1:103 S GAY ST
Practice Address - Street 2:ROOM 714
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-7500
Practice Address - Country:US
Practice Address - Phone:410-779-1576
Practice Address - Fax:410-779-1581
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7372T152W00000X
FL1507152W00000X
KS1142152W00000X
MOT02407152W00000X
OK2085152W00000X
TX2652T152W00000X
WA2001TX152W00000X
WV711-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist