Davidson, Andrew L

Davidson, Andrew L is an individual health care provider with primary practice located at 115 S Tippecanoe Dr , Tipp City OH 45371-1194. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Davidson, Andrew L can be contacted via phone (937) 667-1270.

Contact Information

Primary practice address
115 S Tippecanoe Dr Tipp City OH 45371-1194
Phone: (937) 667-1270
Fax: (937) 667-7198
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3282 Ohio

Profile Details

NPI number 1902854714
LBN Legal business name Davidson, Andrew L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 27th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902854714 NPPES
Ohio Other 3901000001 DMEPOS
Ohio Other 22 20152 DMEPOS
Ohio Other 29152503001 DMEPOS
Ohio Other 000000019255 DMEPOS
Ohio MEDICAID 0416035 DMEPOS

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