Provider Demographics
NPI:1053464073
Name:LOHMAN, ROBERT AMOS I (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:AMOS
Last Name:LOHMAN
Suffix:I
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 SANDY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-8208
Mailing Address - Country:US
Mailing Address - Phone:330-631-5489
Mailing Address - Fax:
Practice Address - Street 1:6720 BASS PRO DR
Practice Address - Street 2:
Practice Address - City:BOSTON HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44236-1198
Practice Address - Country:US
Practice Address - Phone:330-341-7015
Practice Address - Fax:330-341-7014
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3133152W00000X
OHOPT.003133152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2275096Medicaid
OH2275096Medicaid