Provider Demographics
NPI:1073747036
Name:THEFFRON AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:THEFFRON AND ASSOCIATES LLC
Other - Org Name:TRACY HEFFRON OD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:HEFFRON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-934-1152
Mailing Address - Street 1:3681 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8917
Mailing Address - Country:US
Mailing Address - Phone:513-934-1152
Mailing Address - Fax:
Practice Address - Street 1:1530 WALMART DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7342
Practice Address - Country:US
Practice Address - Phone:513-932-2993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5042 T1919152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty