Whitehead, Glen A
Whitehead, Glen A is an sole proprietor health care provider with primary practice located at 2762 Herman Rd , Hamilton OH 45013-9533. He recently has 5 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Whitehead, Glen A can be contacted via phone (513) 892-5961.Contact Information
Primary practice address
2762 Herman Rd
Hamilton OH 45013-9533
Phone: (513) 892-5961
Fax: (513) 892-5962
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3096 | Ohio |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 3096 | Ohio |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 3096 | Ohio |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 3096 | Ohio |
| Eye and Vision Services Providers / Vision Therapy | 152WV0400X | 3096 | Ohio |
Profile Details
| NPI number | 1669578456 |
|---|---|
| LBN Legal business name | Whitehead, Glen A |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Mar 10th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669578456 | NPPES |
| Ohio | MEDICAID | 0227007 |
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