Provider Demographics
NPI:1013959014
Name:BENUTTO, BARBARA M (OD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:BENUTTO
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 1:2250 N BANK DR
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5420
Mailing Address - Country:US
Mailing Address - Phone:614-451-7550
Mailing Address - Fax:614-451-8642
Practice Address - Street 1:6500 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4942
Practice Address - Country:US
Practice Address - Phone:614-798-0266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.004440152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2636071Medicaid
OH2636071Medicaid
OHBE0795015Medicare ID - Type Unspecified
OHBE0795014Medicare ID - Type Unspecified
U59174Medicare UPIN