Provider Demographics
NPI:1629396171
Name:ANDREW J GUNN OD INC
Entity Type:Organization
Organization Name:ANDREW J GUNN OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-745-9735
Mailing Address - Street 1:759 WISTERIA DR
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-4449
Mailing Address - Country:US
Mailing Address - Phone:330-745-9735
Mailing Address - Fax:330-745-5128
Practice Address - Street 1:2000 BRITTAIN RD STE 600
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1814
Practice Address - Country:US
Practice Address - Phone:330-633-0053
Practice Address - Fax:330-633-4274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-08
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3174T805152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty