Provider Demographics
NPI:1518647379
Name:ANDREWS, JAMES IV (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:ANDREWS
Suffix:IV
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:184 MARKET DR
Mailing Address - Street 2:
Mailing Address - City:ATHOL
Mailing Address - State:MA
Mailing Address - Zip Code:01331-9829
Mailing Address - Country:US
Mailing Address - Phone:978-939-3128
Mailing Address - Fax:978-650-2090
Practice Address - Street 1:184 MARKET DR
Practice Address - Street 2:
Practice Address - City:ATHOL
Practice Address - State:MA
Practice Address - Zip Code:01331-9829
Practice Address - Country:US
Practice Address - Phone:978-939-3128
Practice Address - Fax:978-650-2090
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5628152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist