Provider Demographics
NPI:1952468605
Name:ROSENTHAL, RICHARD F (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:F
Last Name:ROSENTHAL
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 1:2978 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-1965
Mailing Address - Country:US
Mailing Address - Phone:614-237-2099
Mailing Address - Fax:614-237-5501
Practice Address - Street 1:2978 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-1965
Practice Address - Country:US
Practice Address - Phone:614-237-2099
Practice Address - Fax:614-237-5501
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4309152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH522119OtherAETNA
OH000000205533OtherANTHEM
OH2200824OtherUNITED HEALTHCARE
OHDR9371791OtherPTAN
OH$$$$$$$$$013OtherMEDICAL MUTUAL
OH522119OtherAETNA