# MARY M FUTCH OD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Baker Vision Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508122854
- **Authorized official:** DR. MARY MARTHA FUTCH OD (PRESIDENT)
- **Authorized official phone:** (904) 259-6259

## Contact information

- **Practice address:** 31 S 6TH ST, MACCLENNY, FL 32063-2311
- **Practice address phone:** (904) 259-6259
- **Practice address fax:** (904) 259-3436
- **Mailing address:** 31 S 6TH ST, MACCLENNY, FL 32063-2311
- **Mailing address phone:** (904) 259-6259
- **Mailing address fax:** (904) 259-3436

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC 2517 | FL | Yes |

## Other

- **Enumeration date:** 04/11/2012
- **Last updated:** 08/06/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1356361208 | NPI | FL |
| 01 | — | 1508122854 | NPI | FL |
| 01 | — | 20312 | BCBS | FL |
| 05 | — | 620401500 | — | FL |
| 01 | — | OC0002221 | PHARMACY CERTIFICATION | — |