Provider Demographics
NPI:1588844468
Name:PAUL J ALTON OD INC
Entity Type:Organization
Organization Name:PAUL J ALTON OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ALTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-282-9800
Mailing Address - Street 1:4650 OBERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3115
Mailing Address - Country:US
Mailing Address - Phone:440-282-9800
Mailing Address - Fax:
Practice Address - Street 1:4650 OBERLIN AVE
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3115
Practice Address - Country:US
Practice Address - Phone:440-282-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3997152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9292051Medicare PIN
OH1174990001Medicare NSC
OHDN6901Medicare PIN
OH410035801Medicare PIN