Provider Demographics
NPI:1942262423
Name:COMPSTON, SHERRY LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LYNN
Last Name:COMPSTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SHERRY
Other - Middle Name:HOGAN
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:416 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2328
Mailing Address - Country:US
Mailing Address - Phone:740-594-2271
Mailing Address - Fax:740-594-2270
Practice Address - Street 1:27843 STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-9060
Practice Address - Country:US
Practice Address - Phone:740-568-0412
Practice Address - Fax:740-568-0413
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4463152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2005681Medicaid
OH2005681Medicaid
U45497Medicare UPIN
OH2005681Medicaid
MC1888291OtherDEA NUMBER
CRO751116Medicare PIN