Individual
MICHAEL H MOOREHEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1360 EATON AVE, HAMILTON, OH 45013-1407
(513) 894-1800
(513) 894-6315
Mailing address
1360 EATON AVE, HAMILTON, OH 45013-1407
(513) 894-1800
(513) 894-6315
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3428
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0720474
—
OH
01
—
410008895
MEDICARE RAILROAD PTAN
OH
Enumeration date
02/06/2006
Last updated
09/12/2015
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