Keith a Bednarczuk OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

3215/T351 Issued in OH

Legal business name

KEITH A BEDNARCZUK OD INC

Practice address

777 Columbus Ave
Suite 12
Lebanon, OH 45036-1684

Phone

(513) 932-3343

Fax

(513) 932-0078

NPI assigned

Jul 22, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Keith A Bednarczuk, O.D.

Title

President

Phone

(513) 932-3343

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280880000000",
    "number": "1104139807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 COLUMBUS AVE",
            "address_2": "SUITE 12",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361684",
            "telephone_number": "513-932-3343",
            "fax_number": "513-932-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 COLUMBUS AVE",
            "address_2": "SUITE 12",
            "city": "LEBANON",
            "state": "OH",
            "postal_code": "450361684",
            "telephone_number": "513-932-3343",
            "fax_number": "513-932-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH A BEDNARCZUK OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-08-04",
        "status": "A",
        "authorized_official_last_name": "BEDNARCZUK",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-932-3343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3215/T351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samia Yaqub Kanooz, MD
• Bill J Karas, M.D.
• Heidi Katehakis
• Elizabeth Boyd Kear, LSW
• Amanda Leigh Keechle, RPH
• Alexa Theresa Keller, DC
• Jennifer Keller
• Michael A Kemner Sr., RPH
• Megan E Kendall, LISW
• Madeline Kenter, LSW

• Optometrist in Lebanon, OH
• Providers in Lebanon, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.