Provider Demographics
NPI:1205820768
Name:GARRITY, JOHN JOSEPH III (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:GARRITY
Suffix:III
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 1:632 VINE ST
Mailing Address - Street 2:STE 301
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-2425
Mailing Address - Country:US
Mailing Address - Phone:513-621-0979
Mailing Address - Fax:513-421-5345
Practice Address - Street 1:632 VINE ST
Practice Address - Street 2:STE 301
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-2425
Practice Address - Country:US
Practice Address - Phone:513-621-0979
Practice Address - Fax:513-421-5345
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4194-T055152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0957675Medicaid
OH0957675Medicaid
GA0731581Medicare PIN