Provider Demographics
NPI:1023295854
Name:JEFFREY C. SEEBOHM, O.D.
Entity type:Organization
Organization Name:JEFFREY C. SEEBOHM, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:SEEBOHM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-554-1018
Mailing Address - Street 1:9016 READING RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:OH
Mailing Address - Zip Code:45215-3230
Mailing Address - Country:US
Mailing Address - Phone:513-554-1018
Mailing Address - Fax:513-554-1096
Practice Address - Street 1:9016 READING RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:OH
Practice Address - Zip Code:45215-3230
Practice Address - Country:US
Practice Address - Phone:513-554-1018
Practice Address - Fax:513-554-1096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3570T644332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0152130001Medicare NSC