Anderson, Staci Dawn
Anderson, Staci Dawn is an sole proprietor health care provider with primary practice located at 2727 Fairfield Commons Blvd , Beavercreek OH 45431-3778. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Anderson, Staci Dawn can be contacted via phone (937) 427-2779.Contact Information
Primary practice address
2727 Fairfield Commons Blvd
Beavercreek OH 45431-3778
Phone: (937) 427-2779
Fax: (937) 427-1527
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5284 | Ohio |
Profile Details
| NPI number | 1558402578 |
|---|---|
| LBN Legal business name | Anderson, Staci Dawn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 11th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558402578 | NPPES |
| Ohio | Other | 220039 | EYEMED PROVIDER ID # |
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