Provider Demographics
NPI:1801051206
Name:OLDING, JACOB ALAN (OD)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:ALAN
Last Name:OLDING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:584 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9002
Mailing Address - Country:US
Mailing Address - Phone:614-895-9955
Mailing Address - Fax:614-895-0913
Practice Address - Street 1:484 COUNTY LINE RD W STE 120
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7110
Practice Address - Country:US
Practice Address - Phone:614-895-9955
Practice Address - Fax:614-895-0913
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5811152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist