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Contact Information

CAROLYN S CLARK, OD
4925 BRADENTON AVE
SUITE A
DUBLIN, OH43017-7532
 Phone: 614-792-1974
 Fax: 614-760-1996
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vision Therapy

152WV0400X 41 Optometry
Indicates primary specialty

NPI Profile & details for CAROLYN S CLARK · (Female)

NPI Number 1013079771
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 12/15/2006
Last updated 05/18/2018 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 4089
  • OH Medicaid 0762509
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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