Provider Demographics
NPI:1942738612
Name:KARRES, MATTHEW LAMARR (OD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:LAMARR
Last Name:KARRES
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 1:65 PENROD AVE
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7543
Mailing Address - Country:US
Mailing Address - Phone:614-266-0770
Mailing Address - Fax:
Practice Address - Street 1:6772 NEW ALBANY CONDIT RD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-9733
Practice Address - Country:US
Practice Address - Phone:614-933-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6552152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist