# HARRIS WILCOX AND DONOVAN PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clay Eye Physicians and Surgeons PA/Fleming Island Optical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023120409
- **Authorized official:** LUCY DINGMAN (BILLING REPRESENTATIVE)
- **Authorized official phone:** (904) 272-2020

## Contact information

- **Practice address:** 2023 PROFESSIONAL CENTER DR, ORANGE PARK, FL 32073-4461
- **Practice address phone:** (904) 272-2020
- **Practice address fax:** (904) 272-5762
- **Mailing address:** 2023 PROFESSIONAL CENTER DR, ORANGE PARK, FL 32073-4461
- **Mailing address phone:** (904) 272-2020
- **Mailing address fax:** (904) 272-5762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | — | NULL | — |
| 152W00000X | Optometrist | — | — | — |
| 156FC0800X | Contact Lens Technician/Technologist | — | NULL | — |
| 156FC0800X | Contact Lens Technician/Technologist | — | — | — |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 332H00000X | Eyewear Supplier | — | NULL | — |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 06/27/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CB1273 | RAIL ROAD MEDICARE | FL |