Provider Demographics
NPI:1821080912
Name:LOY, HEIDI A (OD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:A
Last Name:LOY
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 1:1370 S SAWBURG AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-5761
Mailing Address - Country:US
Mailing Address - Phone:330-821-5367
Mailing Address - Fax:330-821-1981
Practice Address - Street 1:1370 S SAWBURG AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-5761
Practice Address - Country:US
Practice Address - Phone:330-821-5367
Practice Address - Fax:330-821-1981
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4975152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000312626OtherANTHEM BC/BS
OH2098886Medicaid
OHU74903Medicare UPIN
OH000000312626OtherANTHEM BC/BS