Provider Demographics
NPI:1942283262
Name:BABINGTON, S DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:S
Middle Name:DAVID
Last Name:BABINGTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:S
Other - Last Name:BABINGTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:7520 MONTGOMERY BLVD NE
Mailing Address - Street 2:E-6
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1521
Mailing Address - Country:US
Mailing Address - Phone:505-883-1208
Mailing Address - Fax:
Practice Address - Street 1:7520 MONTGOMERY BLVD NE
Practice Address - Street 2:E-6
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1521
Practice Address - Country:US
Practice Address - Phone:505-883-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOP2216152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM-216OtherNM OPTOMETRIC LICENSE
IDO-492OtherIDAHO OPTOMETRIC LICENSE
NMMB0734550OtherDEA NUMBER
NMMB0734550OtherDEA NUMBER