Provider Demographics
NPI:1164688602
Name:OLDING, REBECCA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANN
Last Name:OLDING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:7113 CROFT FARM DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5741
Mailing Address - Country:US
Mailing Address - Phone:330-447-5045
Mailing Address - Fax:
Practice Address - Street 1:1213 N MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1626
Practice Address - Country:US
Practice Address - Phone:740-654-9909
Practice Address - Fax:740-654-9969
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5800152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3048384Medicaid
OHLI4280981OtherMEDICARE PTAN