Provider Demographics
NPI:1780282434
Name:MCCUNE, JOSEPH FLANNERY (DOCTOR OF OPTOMETRY)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FLANNERY
Last Name:MCCUNE
Suffix:
Gender:M
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:DR
Other - First Name:JOE
Other - Middle Name:FLANNERY
Other - Last Name:MCCUNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DOCTOR OF OPTOMETRY
Mailing Address - Street 1:760 BIG GOOSE RD
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-8601
Mailing Address - Country:US
Mailing Address - Phone:724-825-6393
Mailing Address - Fax:
Practice Address - Street 1:380 SE BARRINGTON DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3266
Practice Address - Country:US
Practice Address - Phone:360-675-2235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY437T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist