Provider Demographics
NPI:1801800099
Name:VANDERHORST, KATHRYN D (OD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:D
Last Name:VANDERHORST
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:D
Other - Last Name:LHAMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4409 CHUKBUK CT
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-3802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4555 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-1102
Practice Address - Country:US
Practice Address - Phone:614-876-4044
Practice Address - Fax:614-876-0255
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5665152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist