Provider Demographics
NPI:1851391007
Name:DEEDS, DUANE DOUGLAS (OD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:DOUGLAS
Last Name:DEEDS
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 1:11139 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:OH
Mailing Address - Zip Code:45619-7015
Mailing Address - Country:US
Mailing Address - Phone:740-867-4411
Mailing Address - Fax:740-867-8416
Practice Address - Street 1:11139 COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:OH
Practice Address - Zip Code:45619-7015
Practice Address - Country:US
Practice Address - Phone:740-867-4411
Practice Address - Fax:740-867-8416
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4832152W00000X
WV961-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2026702Medicaid
OH2026702Medicaid
OHDE9341141Medicare ID - Type UnspecifiedGROUP #
OHU67888Medicare UPIN