Individual
DR. KIRK NORWOOD MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7969 W RIDGEWOOD DR, PARMA, OH 44129-5516
(440) 884-3090
(440) 884-1046
Mailing address
1775 E HAYMARKET WAY, HUDSON, OH 44236-4671
(330) 342-9846
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
03419
TX
152W00000X
Optometrist
Primary
3839
OH
152W00000X
Optometrist
OE007297P
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203287006
TAX ID
OH
01
—
34-1569066
FORMER TAX ID
OH
Enumeration date
01/18/2007
Last updated
03/02/2021
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