Provider Demographics
NPI:1518955590
Name:PRICE, CHRISTIAN J (OD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:J
Last Name:PRICE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-2506
Mailing Address - Country:US
Mailing Address - Phone:740-654-4762
Mailing Address - Fax:740-653-7629
Practice Address - Street 1:135 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-2506
Practice Address - Country:US
Practice Address - Phone:740-654-4762
Practice Address - Fax:740-653-7629
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH5335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2345911Medicaid
OH4092174Medicare PIN
OHU91915Medicare UPIN
OH6038580001Medicare NSC
OH4092173Medicare PIN
OH0245790001Medicare NSC
OH4092175Medicare PIN
OHP00464411Medicare PIN