=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700988987
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OHLEN P. CARTMELL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2006
-----------------------------------------------------
Last Update Date | 12/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 316 2ND ST
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45750-2919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-374-3937
-----------------------------------------------------
Fax | 740-376-9437
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 316 2ND ST
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45750-2919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-374-3937
-----------------------------------------------------
Fax | 740-376-9437
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. OHLEN PIERCE CARTMELL
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 740-374-3937
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 4269-T046
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------