Provider Demographics
NPI:1265447221
Name:DRS RONALD COOKE & GEORGE LANDON OPTOMETRISTS LLC
Entity Type:Organization
Organization Name:DRS RONALD COOKE & GEORGE LANDON OPTOMETRISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-367-4262
Mailing Address - Street 1:10051 A SIMONSON ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030
Mailing Address - Country:US
Mailing Address - Phone:513-367-4262
Mailing Address - Fax:513-367-1643
Practice Address - Street 1:10051 A SIMONSON ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030
Practice Address - Country:US
Practice Address - Phone:513-367-4262
Practice Address - Fax:513-367-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5220152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
R09279121Medicare ID - Type UnspecifiedGROUP #