Provider Demographics
NPI:1720431760
Name:LANNING, KARINA DESAI (OD)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:DESAI
Last Name:LANNING
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:PO BOX 207170
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7156
Mailing Address - Country:US
Mailing Address - Phone:636-527-0766
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:105 MOREY DR
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-1647
Practice Address - Country:US
Practice Address - Phone:937-642-2002
Practice Address - Fax:937-642-3620
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002740152W00000X
OH6451152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist