Provider Demographics
NPI:1780650507
Name:ARTHUR, DAVID A (OD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:A
Last Name:ARTHUR
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 1:2187 W BATH RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313
Mailing Address - Country:US
Mailing Address - Phone:330-864-6623
Mailing Address - Fax:330-864-6623
Practice Address - Street 1:20532 SOUTHGATE PARK BLVD
Practice Address - Street 2:
Practice Address - City:MAPLE HTS
Practice Address - State:OH
Practice Address - Zip Code:44137
Practice Address - Country:US
Practice Address - Phone:330-896-3937
Practice Address - Fax:330-896-2926
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2818152W00000X
OH489152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0220620Medicaid
T46121Medicare UPIN
AR0157925Medicare ID - Type Unspecified