Provider Demographics
NPI:1376742452
Name:EBERLE, ANDREA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIE
Last Name:EBERLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10998 OMALLEY CENTRE DR
Mailing Address - Street 2:STE D
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3069
Mailing Address - Country:US
Mailing Address - Phone:907-344-3700
Mailing Address - Fax:907-344-3717
Practice Address - Street 1:10998 OMALLEY CENTRE DR
Practice Address - Street 2:STE D
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3069
Practice Address - Country:US
Practice Address - Phone:907-344-3700
Practice Address - Fax:907-344-3717
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK260152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist