Provider Demographics
NPI:1578511549
Name:BILLINGS, MELISSA (OD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BILLINGS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2699 86TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4309
Mailing Address - Country:US
Mailing Address - Phone:515-270-2490
Mailing Address - Fax:515-270-2494
Practice Address - Street 1:2699 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4309
Practice Address - Country:US
Practice Address - Phone:515-270-2490
Practice Address - Fax:515-270-2494
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02196152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA41662OtherBLUE CROSS
IA410045445OtherRAILROAD MEDICARE
IA410045445OtherRAILROAD MEDICARE
IA41662OtherBLUE CROSS
IAI3249Medicare PIN