Provider Demographics
NPI:1609839943
Name:OATNEY, JAMES BRADLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRADLEY
Last Name:OATNEY
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 1:5766 ASPENDALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-7505
Mailing Address - Country:US
Mailing Address - Phone:614-457-2765
Mailing Address - Fax:
Practice Address - Street 1:3600 OLENTANGY RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3437
Practice Address - Country:US
Practice Address - Phone:614-451-7244
Practice Address - Fax:614-545-0749
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3956152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T48779Medicare UPIN
OA0614282Medicare ID - Type Unspecified
OH0402760001Medicare NSC