Provider Demographics
NPI:1851561211
Name:DR RAY M ATCHERSON PA
Entity Type:Organization
Organization Name:DR RAY M ATCHERSON PA
Other - Org Name:BAY HILLS EYE CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:MORSE
Authorized Official - Last Name:ATCHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:410-757-1350
Mailing Address - Street 1:1294 BAY DALE DR
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2325
Mailing Address - Country:US
Mailing Address - Phone:410-757-1350
Mailing Address - Fax:410-757-7835
Practice Address - Street 1:1294 BAY DALE DR
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2325
Practice Address - Country:US
Practice Address - Phone:410-757-1350
Practice Address - Fax:410-757-7835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTAO 740332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT59919Medicare UPIN
MD859LMedicare PIN
MD4651110001Medicare NSC