Individual
DR. ANDREW L DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
115 S TIPPECANOE DR, TIPP CITY, OH 45371-1194
(937) 667-1270
(937) 667-7198
Mailing address
115 S TIPPECANOE DR, TIPP CITY, OH 45371-1194
(937) 667-1270
(937) 667-7198
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3282
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000019255
ANTHEM BC/BS
OH
05
—
0416035
—
OH
01
—
22 20152
UHC
OH
01
—
29152503001
MEDICAL MUTUAL OF OHIO
OH
01
—
3901000001
DMEPOS
OH
Enumeration date
05/04/2006
Last updated
01/27/2010
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