Provider Demographics
NPI:1497731954
Name:SPRAGUE, EMILY J (OD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:J
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:J
Other - Last Name:TOSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:10 N GREENE ST
Mailing Address - Street 2:VAMHCS BALTIMORE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1524
Mailing Address - Country:US
Mailing Address - Phone:410-605-7230
Mailing Address - Fax:
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:VAMHCS BALTIMORE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2555152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist