Individual
DR. LAWRENCE A GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3814 BROADWAY, GROVE CITY, OH 43123
(614) 871-2080
(614) 871-1301
Mailing address
3814 BROADWAY, GROVE CITY, OH 43123-2234
(614) 871-2080
(614) 871-1301
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2908 T455
OH
152WC0802X
Corneal and Contact Management Optometrist
2908/T455
OH
152WS0006X
Sports Vision Optometrist
2908/T455
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410011215
RAILROAD MEDICARE
OH
Enumeration date
06/16/2005
Last updated
01/08/2016
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