NPI 1265412639 · live from the CMS NPI Registry
Diane C Dewitt, O.D.
Optometrist in Clovis, NM. National Provider Identifier 1265412639, active.
NPI record
| NPI | 1265412639 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1217 Pile St, Clovis, NM 88101 |
| Practice phone | 575-763-5522 |
| Mailing address | Po Box 700, Clovis, NM 88102 |
| Enumerated | January 20, 2006 |
| Last updated | June 15, 2011 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 2364 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.