Provider Demographics
NPI:1437499472
Name:WHEELER, TIFFINIE M (LDO)
Entity Type:Individual
Prefix:
First Name:TIFFINIE
Middle Name:M
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8211 CORNELL RD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-2273
Mailing Address - Country:US
Mailing Address - Phone:513-489-4000
Mailing Address - Fax:
Practice Address - Street 1:8211 CORNELL RD
Practice Address - Street 2:SUITE 510
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2273
Practice Address - Country:US
Practice Address - Phone:513-489-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSC9877156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician