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NPI Code Detail

MEDICARE: DR. LINDA MARIE SEDLACEK O.D.

MEDICARE: DR. LINDA MARIE SEDLACEK O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3787 T643OH

General Provider Information

NPI Number : 1265572549
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LINDA MARIE SEDLACEK O.D.
Provider Business Mailing Address
First Line : 4153 BRIDGEWATER PKWY
Second Line :
City : STOW
State : OH
Zip : 44224-6191
Country : US
Telephone Number : 330-922-4393
Fax Number : 330-922-5901
Provider Business Practice Location Address
First Line : 4153 BRIDGEWATER PKWY
Second Line :
City : STOW
State : OH
Zip : 44224-6191
Country : US
Telephone Number : 330-922-4393
Fax Number : 330-922-5901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 02/11/2009

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