Individual
DR. R. DOUGLAS QUAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE-T008757
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003330
AETNA PIN#
PA
01
—
01395401
BLUE CROSS
PA
01
—
0201390001
MEDICARE DMERC
PA
01
—
51971
DAVIS VISION
PA
01
—
OE-T008757
LICENSE NUMBER
PA
Enumeration date
10/04/2006
Last updated
02/20/2008
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