Provider Demographics
NPI:1417640194
Name:AHMED, FAISAL (DOCTOR OF OPTOMETRY)
Entity Type:Individual
Prefix:DR
First Name:FAISAL
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:DOCTOR OF OPTOMETRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 RED WYNNE LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-8954
Mailing Address - Country:US
Mailing Address - Phone:614-397-3356
Mailing Address - Fax:
Practice Address - Street 1:1455 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5268
Practice Address - Country:US
Practice Address - Phone:405-733-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.007171152W00000X
OK3210152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist