Provider Demographics
NPI:1336274364
Name:MULLEN-WEBER, KAREN ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ANN
Last Name:MULLEN-WEBER
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 1:1107 ALLEN DR STE C
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-8763
Mailing Address - Country:US
Mailing Address - Phone:513-965-2020
Mailing Address - Fax:513-965-2025
Practice Address - Street 1:1107 ALLEN DR STE C
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-8763
Practice Address - Country:US
Practice Address - Phone:513-965-2020
Practice Address - Fax:513-965-2025
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4701152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist