Provider Demographics
NPI:1407028533
Name:RICHARD HARRIS BILLMAN
Entity Type:Organization
Organization Name:RICHARD HARRIS BILLMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:BILLMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:OD
Authorized Official - Phone:740-286-1419
Mailing Address - Street 1:PO 831
Mailing Address - Street 2:201 COLUMBIA ST
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-0831
Mailing Address - Country:US
Mailing Address - Phone:740-286-1419
Mailing Address - Fax:740-286-5546
Practice Address - Street 1:201 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-0831
Practice Address - Country:US
Practice Address - Phone:740-286-1419
Practice Address - Fax:740-286-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0403325Medicaid