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General NPI Number Information
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NPI Number | 1023344538
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Entity Type | Organization
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Legal Business Name | STEPHEN K WHEELER OD LLC
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 06/16/2010
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Provider Practice Location Address
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Address Line | 3465 YORK COMMONS BLVD
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City | DAYTON
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State | OH
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Zip | 45414-2675
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Country | US
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Telephone | 937-454-6450
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Fax | 937-454-6452
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Provider Business Mailing Address
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Address Line | 339 KENDERTON TRL
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City | BEAVERCREEK
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State | OH
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Zip | 45430-2062
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Country | US
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Telephone | 937-477-3527
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHEN WHEELER
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Credential | O.D.
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Telephone | 937-477-3527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3006
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License Number State | OH
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