Provider Demographics
NPI:1750722575
Name:OZBOLD, JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:OZBOLD
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 1:125 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-2081
Mailing Address - Country:US
Mailing Address - Phone:814-472-9670
Mailing Address - Fax:814-472-9670
Practice Address - Street 1:125 MANOR DR
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-2081
Practice Address - Country:US
Practice Address - Phone:814-472-9670
Practice Address - Fax:814-472-9670
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist