Provider Demographics
NPI:1497181176
Name:LUGAR, REBECCA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:LUGAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1500 POLARIS PKWY
Mailing Address - Street 2:STE 2012
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-2126
Mailing Address - Country:US
Mailing Address - Phone:614-880-8196
Mailing Address - Fax:614-880-9194
Practice Address - Street 1:1500 POLARIS PKWY
Practice Address - Street 2:STE 2012
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2126
Practice Address - Country:US
Practice Address - Phone:614-880-8196
Practice Address - Fax:614-880-9194
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist