Provider Demographics
NPI:1467405100
Name:DR STEPHANIE MCDONALD OD LLC
Entity Type:Organization
Organization Name:DR STEPHANIE MCDONALD OD LLC
Other - Org Name:DR JASON PITTSER AND DR STEPHANIE MCDONALD OPTOMETRIC PARTNERSHIP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:STINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-335-1181
Mailing Address - Street 1:7 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-2166
Mailing Address - Country:US
Mailing Address - Phone:740-335-1181
Mailing Address - Fax:740-335-1182
Practice Address - Street 1:7 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-2166
Practice Address - Country:US
Practice Address - Phone:740-335-1181
Practice Address - Fax:740-335-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9361561Medicare PIN
OH5676240001Medicare NSC