Provider Demographics
NPI:1942462635
Name:THATCHER, PAULA MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:MARIE
Last Name:THATCHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8315 BEECHMONT AVE.
Mailing Address - Street 2:SUITE 33
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-3131
Mailing Address - Country:US
Mailing Address - Phone:513-474-4444
Mailing Address - Fax:513-474-7915
Practice Address - Street 1:8315 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-6140
Practice Address - Country:US
Practice Address - Phone:513-474-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5890152W00000X
KY1796DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200904380Medicaid
OH4276654OtherPTAN / HAMILTON
OH4276655OtherPTAN / BEECHMONT
OH4276658OtherPTAN / LIBERTY TOWNSHIP
KY740716OtherPTAN / KENTUCKY
OH4276651OtherPTAN / HYDE PARK
OH4276653OtherPTAN / KENWOOD
OH4276652OtherPTAN / COLERAIN
OH4276651OtherPTAN / GLENWAY
OH4276656OtherPTAN / TRI COUNTY
OH4276657OtherPTAN / SYMMES
OH4276652OtherPTAN / COLERAIN
OH4276654OtherPTAN / HAMILTON
OH4276651OtherPTAN / GLENWAY
IN825700NNNMedicare PIN