National Provider Identifier
Michael Dale Mortimer, O.D.
Michael Dale Mortimer, O.D. is listed in the NPPES registry with a primary specialty of Optometrist in Olean, NY and a listed phone number of (716) 372-8644.
Profile Overview
- NPI
- 1801881578
- Provider Type
- Individual
- Primary Specialty
- Optometrist
- Enumeration Date
- September 19, 2005
- Last Updated
- January 21, 2009
Practice Location
- 130 S Union St
- Ste. 8
- Olean, NY 14760-9807
Phone: (716) 372-8644
Specialties
- Optometrist (152W00000X)
Full Record
- NPI
- 1801881578
- Entity Type
- Individual
- Last Name
- Mortimer
- First Name
- Michael
- Middle Name
- Dale
- Name Prefix
- Dr.
- Credential
- O.D.
- Mailing Street Address
- 130 S Union St
- Mailing Address Line 2
- Ste. 8
- Mailing City
- Olean
- Mailing State
- NY
- Mailing ZIP Code
- 14760-9807
- Mailing Country
- US
- Mailing Phone
- (716) 372-8644
- Mailing Fax
- (716) 373-4257
- Practice Street Address
- 130 S Union St
- Practice Address Line 2
- Ste. 8
- Practice City
- Olean
- Practice State
- NY
- Practice ZIP Code
- 14760-9807
- Practice Country
- US
- Practice Phone
- (716) 372-8644
- Practice Fax
- (716) 373-4257
- Enumeration Date
- September 19, 2005
- Last Updated
- January 21, 2009
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optometrist (152W00000X)
- Other Identifiers
- NY3906 (NY, Eyemed), 00606964 (NY)