Individual
DR. LAIRD DOUGLAS ACKERSON
Active
Individual
DR. LAIRD DOUGLAS ACKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3586/T1086
OH
152WC0802X
Corneal and Contact Management Optometrist
3586/T1086
OH
152WP0200X
Pediatric Optometrist
3586/T1086
OH
152WS0006X
Sports Vision Optometrist
3586/T1086
OH
152WV0400X
Vision Therapy Optometrist
3586/T1086
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000323515
ANTHEM BC/BS PROVIDER
OH
01
—
04-3743736
FED TAX ID
OH
01
—
2200005
UNITED HEATHCARE PROVIDER
OH
01
—
DE3942
RAILROAD MEDICARE GRP NO.
OH
01
—
P00289883
RAILROAD MEDICARE B PIN
OH
Enumeration date
07/27/2006
Last updated
03/20/2009
Update your record
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