Organization
KEITH A. HUELSMAN OD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH ALLEN HUELSMAN OD (DOCTOR)
(937) 901-4902
Entity
Organization
Contact information
Practice address
4301 STATE ROUTE 725, BELLBROOK, OH 45305-1552
(937) 848-3393
Mailing address
4301 STATE ROUTE 725, BELLBROOK, OH 45305-1552
(937) 848-3393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4200
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114040
EYEMED
—
01
—
17615
ANTHEM
—
01
—
304246
ANTHEM
—
Enumeration date
09/06/2007
Last updated
03/25/2008
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