Provider Demographics
NPI:1689604324
Name:DOUDNA, AARON S (OD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:S
Last Name:DOUDNA
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 1:60691 GREENLAWN RD
Mailing Address - Street 2:
Mailing Address - City:QUAKER CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43773-9688
Mailing Address - Country:US
Mailing Address - Phone:740-439-1098
Mailing Address - Fax:740-439-3165
Practice Address - Street 1:1335 SOUTHGATE PKWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-3015
Practice Address - Country:US
Practice Address - Phone:740-439-1098
Practice Address - Fax:740-439-3165
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4641/T1416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH452082001OtherDMERC PROVIDER #
OH9321631OtherMEDICARE GROUP NUMBER
OH410049131OtherRAILROAD MEDICARE
OH0169366/6566685Medicaid
OH0169366/6566685Medicaid
OH452082001OtherDMERC PROVIDER #