Provider Demographics
NPI:1144648064
Name:RICHARDSON OPTOMETRIC INC
Entity type:Organization
Organization Name:RICHARDSON OPTOMETRIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:N
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-633-3556
Mailing Address - Street 1:10499 WHITE ASH TRL
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-2659
Mailing Address - Country:US
Mailing Address - Phone:330-633-3556
Mailing Address - Fax:330-633-3703
Practice Address - Street 1:2000 BRITTAIN RD STE 10
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1813
Practice Address - Country:US
Practice Address - Phone:330-633-3556
Practice Address - Fax:330-633-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4075152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty