Healthcare Provider Details
I. General information
NPI: 1790711422
Provider Name (Legal Business Name): ANN KURZER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/24/2006
Last Update Date: 01/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6150 GLENWAY AVE
CINCINNATI OH
45211-6319
US
IV. Provider business mailing address
8511 GURNEY CT
DAYTON OH
45458-2678
US
V. Phone/Fax
- Phone: 513-233-7220
- Fax: 513-389-0689
- Phone: 937-620-3899
- Fax: 513-741-6433
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 3810 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WC0802X |
| Taxonomy | Corneal and Contact Management Optometrist |
| License Number | 3810 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: