Provider Demographics
NPI:1821581554
Name:WARD, ERIC (OD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WARD
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 1:39340 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-2100
Mailing Address - Country:US
Mailing Address - Phone:440-371-8693
Mailing Address - Fax:
Practice Address - Street 1:35825 DETROIT RD STE 107
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-3001
Practice Address - Country:US
Practice Address - Phone:440-937-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006670152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist