Tarra Lynn Goble, OPTICIAN
Individual provider Active NPI Optician · Wapakoneta, OH
NPI 1841997384 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1841997384
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- OP.010598-SC (OH)
- Practice address
- 1257 Bellefontaine St
Wapakoneta, OH 45895-9732 - Phone
- (419) 738-0494
- Fax
- (419) 738-0496
- NPI assigned
- Feb 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OP.010598-SC | OH | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | OP.010598-SC | OH | Yes |
Addresses
Primary practice location
1257 Bellefontaine St
Wapakoneta, OH 45895-9732
Mailing address
1257 Bellefontaine St
Wapakoneta, OH 45895-9732
Phone (419) 738-0494
Other providers in Wapakoneta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.