Individual
JOHN A GAZAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1520T
IA
152W00000X
Optometrist
Primary
2009002132
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057075
—
IA
01
—
05707
BLUE SHIELD
IA
Enumeration date
10/03/2006
Last updated
09/01/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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