Healthcare Provider Details

I. General information

NPI: 1982986204
Provider Name (Legal Business Name): DUBLIN FAMILY VISION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4925 BRADENTON AVE SUITE A
DUBLIN OH
43017-7532
US

IV. Provider business mailing address

4925 BRADENTON AVE SUITE A
DUBLIN OH
43017-7532
US

V. Phone/Fax

Practice location:
  • Phone: 614-792-1974
  • Fax: 614-760-1996
Mailing address:
  • Phone: 614-792-1974
  • Fax: 614-760-1996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. CAROLYN SUE CLARK
Title or Position: OWNER
Credential: O.D.
Phone: 614-792-1974