Provider Demographics
NPI:1992023006
Name:LUCY PICKERING OD LLC
Entity Type:Organization
Organization Name:LUCY PICKERING OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKERING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-395-2957
Mailing Address - Street 1:126 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1105
Mailing Address - Country:US
Mailing Address - Phone:614-395-2957
Mailing Address - Fax:
Practice Address - Street 1:126 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1105
Practice Address - Country:US
Practice Address - Phone:614-395-2957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5671152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1376716514OtherTYPE I NPI (LUCY PICKERING OD)