Provider Demographics
NPI:1487654620
Name:DEEDS, ANNE MICHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MICHELLE
Last Name:DEEDS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 4TH ST. E
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680
Mailing Address - Country:US
Mailing Address - Phone:740-867-4411
Mailing Address - Fax:740-867-8416
Practice Address - Street 1:604 4TH ST. E
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680
Practice Address - Country:US
Practice Address - Phone:740-867-4411
Practice Address - Fax:740-867-8416
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4890/T1755152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2017525Medicaid
OHDE9341141Medicare ID - Type UnspecifiedGROUP #
OH2017525Medicaid
OHDE0838756Medicare PIN