Provider Demographics
NPI:1619085800
Name:GINIER, ALVIN (OD)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:GINIER
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 1:5170 US ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2004
Mailing Address - Country:US
Mailing Address - Phone:304-522-7616
Mailing Address - Fax:317-259-1538
Practice Address - Street 1:5170 US ROUTE 60
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-2004
Practice Address - Country:US
Practice Address - Phone:304-522-7616
Practice Address - Fax:317-259-4234
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5581152W00000X
PAOEG001717152W00000X
IN18004325152W00000X
WV1030-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810005320Medicaid
OH3147455Medicaid
OHH000390Medicare PIN
WVWV4367C197Medicare PIN
WV4181211Medicare PIN
WVV09085Medicare UPIN