Individual
DR. DAVID A. NIEDERKOHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
25 NORTHWOOD DR, DELAWARE, OH 43015-1501
(740) 369-7701
(740) 369-0021
Mailing address
10197 ABBOTTS WAY, POWELL, OH 43065-6652
(614) 785-9858
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3260T1062
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000117913
ANTHEM BC/BS
—
01
—
0005353619
AETNA
—
05
—
0349813
—
OH
01
—
17042
SPECTERA
OH
01
—
311001012003
MEDICAL MUTUAL
OH
01
—
3230
DAVIS VISION
—
01
—
OH1062
EYEMED
OH
Enumeration date
11/01/2006
Last updated
05/22/2012
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