Provider Demographics
NPI:1720205743
Name:BINNIG, ELISABETH J (OD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:J
Last Name:BINNIG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 N STATE ST STE 210
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7135
Mailing Address - Country:US
Mailing Address - Phone:614-596-3183
Mailing Address - Fax:
Practice Address - Street 1:570 N STATE ST STE 210
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7135
Practice Address - Country:US
Practice Address - Phone:614-596-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4422T997152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0915433Medicaid
OHU41319Medicare UPIN
OH0915433Medicaid