Provider Demographics
NPI:1134166986
Name:COWARD, DAVID JAMES (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:COWARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:JAMES
Other - Last Name:COWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 12134
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-2134
Mailing Address - Country:US
Mailing Address - Phone:312-771-7411
Mailing Address - Fax:
Practice Address - Street 1:200 N COOPER DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4016
Practice Address - Country:US
Practice Address - Phone:252-430-7708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist