Provider Demographics
NPI:1265425755
Name:ANDREWS, JAMES WILLIAM (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:ANDREWS
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 1:5062 MOBILE HWY
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-3240
Mailing Address - Country:US
Mailing Address - Phone:850-453-4373
Mailing Address - Fax:850-453-1953
Practice Address - Street 1:5062 MOBILE HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-3240
Practice Address - Country:US
Practice Address - Phone:850-453-4373
Practice Address - Fax:850-453-1953
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC001391152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043497209OtherORGANIZATIONAL NPI
FLT93874Medicare UPIN
FL1193850001Medicare NSC
FL19282Medicare PIN