Healthcare Provider Details

I. General information

NPI: 1407028533
Provider Name (Legal Business Name): RICHARD HARRIS BILLMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2008
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 COLUMBIA ST
JACKSON OH
45640-0831
US

IV. Provider business mailing address

PO 831 201 COLUMBIA ST
JACKSON OH
45640-0831
US

V. Phone/Fax

Practice location:
  • Phone: 740-286-1419
  • Fax: 740-286-5546
Mailing address:
  • Phone: 740-286-1419
  • Fax: 740-286-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD HARRIS BILLMAN II
Title or Position: OWNER
Credential: OD
Phone: 740-286-1419