Provider Demographics
NPI:1770871618
Name:ANSPAUGH, MELANIE (OD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:ANSPAUGH
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 1:6677 W THUNDERBIRD RD STE F101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-3723
Mailing Address - Country:US
Mailing Address - Phone:623-878-3939
Mailing Address - Fax:480-393-5144
Practice Address - Street 1:6677 W THUNDERBIRD RD STE F101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-3723
Practice Address - Country:US
Practice Address - Phone:623-878-3939
Practice Address - Fax:480-393-5144
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8846T152W00000X
WAOD60282144152W00000X
AZOPT-001975152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8846TGOtherLICENSE