Provider Demographics
NPI:1457350530
Name:OHLE, DAVID M (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:OHLE
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 1:635 PARK MEADOW RD STE 213
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2877
Mailing Address - Country:US
Mailing Address - Phone:614-565-9002
Mailing Address - Fax:866-288-3797
Practice Address - Street 1:635 PARK MEADOW RD STE 213
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2877
Practice Address - Country:US
Practice Address - Phone:614-392-2256
Practice Address - Fax:866-288-3797
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4959 T1829152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00274361OtherRAILROAD MEDICARE
OH2133186Medicaid
OH2133186Medicaid
OHP00274361OtherRAILROAD MEDICARE