Provider Demographics
NPI:1679207377
Name:SLATER WHITT, RACHEL DENISE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DENISE
Last Name:SLATER WHITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 WARDS CORNER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6966
Mailing Address - Country:US
Mailing Address - Phone:513-576-7700
Mailing Address - Fax:513-576-1020
Practice Address - Street 1:1341 CLOUGH PIKE STE 150
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-2503
Practice Address - Country:US
Practice Address - Phone:513-732-5082
Practice Address - Fax:513-214-2408
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH007190152W00000X
IN18004337A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0022099Medicaid