Provider Demographics
NPI:1033299532
Name:T. R. STAHL & ASSOC. INC.
Entity Type:Organization
Organization Name:T. R. STAHL & ASSOC. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:KITCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-258-1515
Mailing Address - Street 1:3085 WOODMAN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1159
Mailing Address - Country:US
Mailing Address - Phone:937-258-1515
Mailing Address - Fax:937-258-4128
Practice Address - Street 1:3085 WOODMAN DR STE 100
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45420-1159
Practice Address - Country:US
Practice Address - Phone:937-258-1515
Practice Address - Fax:937-258-4128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9345541Medicare ID - Type Unspecified