Healthcare Provider Details

I. General information

NPI: 1538569272
Provider Name (Legal Business Name): DUBLIN PERCEPTIVE EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2014
Last Update Date: 08/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6465 SAWMILL RD
DUBLIN OH
43017-9007
US

IV. Provider business mailing address

6465 SAWMILL RD
DUBLIN OH
43017-9007
US

V. Phone/Fax

Practice location:
  • Phone: 614-000-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number6072
License Number StateOH

VIII. Authorized Official

Name: DR. TABINDA SHAH
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 330-608-6284