NPI 1447319405

Charles Lee Mellinger, OD

Practitioner Optometrist Southport, CT

Practice location

Address: 2600 Post Rd, Southport, CT 06890
Phone: (203) 255-4005
Mailing address: 85 Half Mile Lane, Southport, CT 06890

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 0000841 (CT)

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Registry record

NPI: 1447319405
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Dec 2006
Record last updated: 25 Oct 2010

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.