Provider Demographics
NPI:1508949116
Name:OMAN, HEATHER HANFORD (OD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:HANFORD
Last Name:OMAN
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 1:1607 WESTOVER TER
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-1996
Mailing Address - Country:US
Mailing Address - Phone:336-288-3937
Mailing Address - Fax:336-288-8177
Practice Address - Street 1:2100 W CORNWALLIS DR STE J
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-7015
Practice Address - Country:US
Practice Address - Phone:336-288-3937
Practice Address - Fax:336-288-8177
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC1759152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2200377OtherUNITED HEALTH CARE
NC89093F3Medicaid
NC093F3OtherBLUE CROSS BLUE SHIELD NC
NCD7691OtherMEDCOST
NCP00174673OtherRAILROAD MEDICARE
NC2200377OtherUNITED HEALTH CARE
NC89093F3Medicaid