Provider Demographics
NPI:1356536668
Name:BRETT D MCVEY OD INC
Entity type:Organization
Organization Name:BRETT D MCVEY OD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCVEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-246-2020
Mailing Address - Street 1:209 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-1609
Mailing Address - Country:US
Mailing Address - Phone:440-246-2020
Mailing Address - Fax:440-244-3257
Practice Address - Street 1:209 W 5TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-1609
Practice Address - Country:US
Practice Address - Phone:440-246-2020
Practice Address - Fax:440-244-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3622T559152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBR9293471Medicare PIN
OH1223640001Medicare NSC