Provider Demographics
NPI:1851584148
Name:JULIE M HEIDISH OD INC
Entity Type:Organization
Organization Name:JULIE M HEIDISH OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEIDISH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-983-6171
Mailing Address - Street 1:3384 STATE ROUTE 752
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43103-9685
Mailing Address - Country:US
Mailing Address - Phone:740-983-6171
Mailing Address - Fax:740-983-6587
Practice Address - Street 1:3384 STATE ROUTE 752
Practice Address - Street 2:
Practice Address - City:ASHVILLE
Practice Address - State:OH
Practice Address - Zip Code:43103-9685
Practice Address - Country:US
Practice Address - Phone:740-983-6171
Practice Address - Fax:740-983-6587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4661152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1306843727OtherINDIVIDUAL NPI
OH1851584148OtherGROUP NPI
OH1669509428OtherINDIVIDUAL NPI
U61732Medicare UPIN
OH6073620001Medicare NSC
OH9370801Medicare PIN
OH1851584148OtherGROUP NPI