MEDICARE: DR. DANIEL C DROUGHT O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	4017/T415	OH
2	152WL0500X	Low Vision Rehabilitation Optometrist	4017/T415	OH
3	152WX0102X	Occupational Vision Optometrist	4017 T415	OH
4	152W00000X	Optometrist	4017/T415	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000138384	OTHER	OH	BLUE CROSS BLUE SHIELD
2	34 1776888	OTHER	OH	CENTRAL BENEFITS
3	2377231	OTHER	OH	AETNA
4	34 1776888	OTHER	OH	AARP
5	34 1776888	OTHER	OH	MUTUAL OF OMAHA
6	34 1776888	OTHER	OH	UNITED FOOD
7	34 1776888	OTHER	OH	PRINCIPAL
8	34 1776888	OTHER	OH	CIGNA
9	34 1776888	OTHER	OH	HM BENEFITS
10	34 1776888	OTHER	OH	HEALTH DESIGN PLUS
11	34 1776888	OTHER	OH	CARPENTERS
12	34 1776888	OTHER	OH	PYRAMID
13	34 1776888	OTHER	OH	BRICKLAYERS
14	34 1776888	OTHER	OH	STATE FARM
15	57052	OTHER	OH	WORKERS COMPENSATIONS
16	341776888001	OTHER	OH	MEDICAL MUTUAL

General Provider Information

NPI Number	:	1255474482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL C DROUGHT O.D.

Provider Business Mailing Address
First Line	:	PO BOX 389
Second Line	:
City	:	GENEVA
State	:	OH
Zip	:	44041-0389
Country	:	US
Telephone Number	:	440-466-4661
Fax Number	:	440-466-3363

Provider Business Practice Location Address
First Line	:	895 S BROADWAY
Second Line	:
City	:	GENEVA
State	:	OH
Zip	:	44041-9146
Country	:	US
Telephone Number	:	440-466-4661
Fax Number	:	440-466-3363

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	09/25/2024

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