Individual
DR. THEODORE D KRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
920 W MAIN ST, BRIDGEPORT, WV 26330-1651
(304) 842-4444
(304) 842-4491
Mailing address
100 W MAIN ST, STE A, BUCKHANNON, WV 26201-2292
(304) 842-4444
(304) 842-4491
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
958-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720797
BCBS
WV
05
—
0150098000
—
WV
01
—
1346240413
NPI
WV
01
—
410042363
RAILROAD
WV
01
—
P00247169
RAILROAD
WV
01
—
P00440067
RAILROAD
WV
Enumeration date
07/29/2005
Last updated
08/25/2016
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