Organization
JOSEPH M. BANNON OD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH M. BANNON O.D. (PRESIDENT)
(304) 234-4455
Entity
Organization
Contact information
Practice address
1021 NATIONAL RD, WHEELING, WV 26003-5779
(304) 234-4455
Mailing address
1021 NATIONAL RD, WHEELING, WV 26003-5779
(304) 234-4455
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3766
OH
152W00000X
Optometrist
Primary
797D
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410045514
MEDICARE-RAILROAD
—
Enumeration date
11/06/2006
Last updated
08/05/2008
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