Healthcare Provider Details

I. General information

NPI: 1669945739
Provider Name (Legal Business Name): ERIN LEIGH MEFFAN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1790 TOWN PARK BLVD STE D
UNIONTOWN OH
44685-7972
US

IV. Provider business mailing address

PO BOX 207170
DALLAS TX
75320-7170
US

V. Phone/Fax

Practice location:
  • Phone: 330-896-3937
  • Fax: 330-896-2926
Mailing address:
  • Phone: 636-200-4393
  • Fax: 636-527-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT00.6721
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: