Provider Demographics
NPI:1942205448
Name:ENGLAND, DAVID STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STEVEN
Last Name:ENGLAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1710
Mailing Address - Country:US
Mailing Address - Phone:541-482-8100
Mailing Address - Fax:541-488-5081
Practice Address - Street 1:648 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1710
Practice Address - Country:US
Practice Address - Phone:541-482-8100
Practice Address - Fax:541-488-5081
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2913T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK004515007OtherBLUE CROSS/BLUE SHIELD
OR298084Medicaid
OR0000WCPBQOtherMEDICARE GROUP NUMBER
ORP00013346OtherRR MEDICARE
OR115735Medicare PIN
OR0000WCPBQOtherMEDICARE GROUP NUMBER