Individual
CLYDE M FENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2002 ROBINSON AVE, PORTSMOUTH, OH 45662-3650
(740) 353-5351
(740) 353-8647
Mailing address
2002 ROBINSON AVE, PORTSMOUTH, OH 45662-3650
(740) 353-5351
(740) 353-8647
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3023
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0344541
—
OH
Enumeration date
12/13/2006
Last updated
09/03/2013
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