Provider Demographics
NPI:1861178428
Name:BOEHME, DAVID J (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BOEHME
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:2576 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-4301
Mailing Address - Country:US
Mailing Address - Phone:724-378-8585
Mailing Address - Fax:724-375-1574
Practice Address - Street 1:6305 LIBRARY RD
Practice Address - Street 2:
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-8502
Practice Address - Country:US
Practice Address - Phone:412-854-4130
Practice Address - Fax:412-854-8175
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2024-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOEG004055152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes152W00000XEye and Vision Services ProvidersOptometrist