Provider Demographics
NPI:1316199953
Name:CORREA, ELIZABETH C (OD)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:C
Last Name:CORREA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:CHRISTINE
Other - Last Name:CORREA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:10782 RUSHDEN CT
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-7424
Mailing Address - Country:US
Mailing Address - Phone:614-325-0512
Mailing Address - Fax:
Practice Address - Street 1:2751 BLUE ROCK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6332
Practice Address - Country:US
Practice Address - Phone:513-741-4000
Practice Address - Fax:513-741-4056
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHT2530152WC0802X
OH5616152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management