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Individual

DR. RICHARD LEE SHRODER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
899 N BROADWAY, LEBANON, OH 45036-1361
(513) 932-1976
(513) 932-1976
Mailing address
899 N BROADWAY, LEBANON, OH 45036-1361
(513) 932-1976
(513) 932-1976

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2696T741
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000003878
ANTHEM
OH
01
000000249581
ANTHEM
OH
Enumeration date
09/19/2006
Last updated
07/09/2007
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