Healthcare Provider Details

I. General information

NPI: 1821090614
Provider Name (Legal Business Name): JAMES COOKE BIEBER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2098 TREMONT CTR
COLUMBUS OH
43221-3108
US

IV. Provider business mailing address

2098 TREMONT CTR
COLUMBUS OH
43221-3108
US

V. Phone/Fax

Practice location:
  • Phone: 614-486-5205
  • Fax: 614-486-0354
Mailing address:
  • Phone: 614-486-5205
  • Fax: 614-486-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2756 T356
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number2756 T356
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number2756 T356
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: