B. Michael Southam, Od, PC
NPI #1912562596 in Winnemucca, Nevada
Provider Information
- NPI Number
- 1912562596
- Entity Type
- Organization
- Organization Name
- B. Michael Southam, Od, PC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- B. MICHAEL SOUTHAM OD, PC
- Primary Specialty
- Optometrist
- Enumeration Date
- May 8, 2019
- Last Updated
- May 8, 2019
Practice Location
- Address
- 625 SHEEHAN ST APT E
- City
- Winnemucca
- State
- Nevada
- ZIP Code
- 89445-3675
- Phone
- (775) 625-4733
Authorized Official
- Name
- KATHRYN SOUTHAM
- Title
- MANAGER
- Phone
- (775) 825-0559
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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