Provider Demographics
NPI:1619003787
Name:GIOVANETTI, JOSEPH A (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:GIOVANETTI
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 1:5537 BRIDGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4329
Mailing Address - Country:US
Mailing Address - Phone:513-574-2233
Mailing Address - Fax:513-574-3937
Practice Address - Street 1:5537 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-4329
Practice Address - Country:US
Practice Address - Phone:513-574-2233
Practice Address - Fax:513-574-3937
Is Sole Proprietor?:No
Enumeration Date:2007-02-25
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3859-T458152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH22-01202OtherUNITED HEALTHCARE INS
OH3859-T458OtherOHIO OPTOMETRY LICENSE
OH0408777Medicaid
OH000000019418OtherANTHEM INSURANCE
OH628123OtherMEDICARE ID
OH3859-T458OtherOHIO OPTOMETRY LICENSE
OH0408777Medicaid
OH628123OtherMEDICARE ID