Individual
DR. TIFFANY PROCACCINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
320 W WALTON ST, WILLARD, OH 44890-9133
(419) 933-2741
Mailing address
PO BOX 270, WILLARD, OH 44890-0270
(419) 933-2741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5906
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043330871
GROUP NPI
OH
01
—
1912136755
INDIVIDUAL NPI
OH
05
—
2988521
—
OH
01
—
9292043
GROUP PTAN
OH
01
—
CG0387
RAILROAD MEDICARE GROUP PTAN
OH
01
—
H060602
INDIVIDUAL PTAN
OH
01
—
P01269559
RAILROAD MEDCIARE PTAN
OH
Enumeration date
07/14/2009
Last updated
11/05/2025
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