Healthcare Provider Details

I. General information

NPI: 1629146972
Provider Name (Legal Business Name): RICHARD E. HULTS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 01/20/2020
Certification Date: 01/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3265 W. MARKET ST.
AKRON OH
44333
US

IV. Provider business mailing address

PO BOX 880
HUDSON OH
44236-5880
US

V. Phone/Fax

Practice location:
  • Phone: 330-836-2200
  • Fax: 866-425-2239
Mailing address:
  • Phone: 330-687-4748
  • Fax: 866-425-2239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number3420
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3420
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: