Provider Demographics
NPI:1043438419
Name:MUNZEL, BETHANY ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:ANN
Last Name:MUNZEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:BETHANY
Other - Middle Name:ANN
Other - Last Name:BUSEMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:2236 SUFFOLK STREET
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-1431
Mailing Address - Country:US
Mailing Address - Phone:513-232-0882
Mailing Address - Fax:
Practice Address - Street 1:3101 BURNET AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3014
Practice Address - Country:US
Practice Address - Phone:513-357-7289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4728T1532152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist