Healthcare Provider Details

I. General information

NPI: 1306635552
Provider Name (Legal Business Name): MAKAYLA HALL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MAKAYLA HOWARD

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1945 CEI DR
BLUE ASH OH
45242-5664
US

IV. Provider business mailing address

PO BOX 736502
CHICAGO IL
60673-1408
US

V. Phone/Fax

Practice location:
  • Phone: 513-296-8332
  • Fax:
Mailing address:
  • Phone: 740-970-2016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2449DT
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT.007414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: