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SPECTRUM OPTICAL PLLC NPI 1255486882


NPI Information

NPI: 1255486882
Provider Name: SPECTRUM OPTICAL PLLC

Former Legal Business Name: SPECTRUM OPTICAL LLC

Classification: Optometrist - 152W00000X
Entity Type: Organization

CLIA Number: 51D2097135

Address:
1257 PINEVIEW DR
MORGANTOWN, WV
ZIP 26505
Phone: (304) 599-7034
Get Directions

SPECTRUM OPTICAL PLLC is an optometrist in Morgantown, WV. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. SPECTRUM OPTICAL PLLC NPI is 1255486882. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Spectrum Optical Llc.

The provider's business location address is:

1257 PINEVIEW DR
MORGANTOWN, WV
ZIP 26505-713
Phone: (304) 599-7034
Fax: (304) 599-5483

The provider's authorized official is Richard Henry Goellner .
The authorized official title is Managing Partner and has the following contact phone number (304) 599-7034.

The CLIA number assigned to this NPI record is 51D2097135 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2007 and was last updated on 8/12/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13810002839MEDICAIDWEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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