Provider Demographics
NPI:1902015639
Name:SAWICKI, DARLA LEFOER (OD)
Entity Type:Individual
Prefix:DR
First Name:DARLA
Middle Name:LEFOER
Last Name:SAWICKI
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 1:6105 BROADWELL CT
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8516
Mailing Address - Country:US
Mailing Address - Phone:614-878-0587
Mailing Address - Fax:614-878-2242
Practice Address - Street 1:6105 BROADWELL CT
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8516
Practice Address - Country:US
Practice Address - Phone:614-878-0587
Practice Address - Fax:614-878-2242
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4855152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU68750Medicare UPIN