Organization
CLYDE M. FENTON, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE M FENTON (OWNER)
(740) 353-5351
Entity
Organization
Contact information
Practice address
2002 ROBINSON AVE, PORTSMOUTH, OH 45662-3650
(740) 353-5351
Mailing address
2002 ROBINSON AVE, PORTSMOUTH, OH 45662-3650
(740) 353-5351
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0544680001
DMERC REGION B
OH
Enumeration date
06/26/2008
Last updated
12/15/2015
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