Provider Demographics
NPI:1528200318
Name:DONNA L. ELCOCK, O.D.
Entity Type:Organization
Organization Name:DONNA L. ELCOCK, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ELCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-284-0777
Mailing Address - Street 1:538 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3102
Mailing Address - Country:US
Mailing Address - Phone:610-284-0777
Mailing Address - Fax:610-284-2808
Practice Address - Street 1:538 CHURCH LN
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3102
Practice Address - Country:US
Practice Address - Phone:610-284-0777
Practice Address - Fax:610-284-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001054152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty