Healthcare Provider Details

I. General information

NPI: 1457350530
Provider Name (Legal Business Name): DAVID M. OHLE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 PARK MEADOW RD STE 213
WESTERVILLE OH
43081-2877
US

IV. Provider business mailing address

635 PARK MEADOW RD STE 213
WESTERVILLE OH
43081-2877
US

V. Phone/Fax

Practice location:
  • Phone: 614-392-2256
  • Fax: 866-288-3797
Mailing address:
  • Phone: 614-565-9002
  • Fax: 866-288-3797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4959 T1829
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: