NPI 1073599429

R. Michael Fewell, OD

Practitioner Optometrist Kokomo, IN

Practice location

Address: 3421 S Lafountain St Suite a, Kokomo, IN 46902-3801
Phone: (765) 455-0404
Fax: (765) 455-1765

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 18001678B (IN)

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Registry record

NPI: 1073599429
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Dec 2005
Record last updated: 27 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.