Provider Demographics
NPI:1063767176
Name:BARTHOLOMEW, ALLEN (OD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:BARTHOLOMEW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3888 STELZER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-3044
Mailing Address - Country:US
Mailing Address - Phone:614-934-6226
Mailing Address - Fax:
Practice Address - Street 1:3888 STELZER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3044
Practice Address - Country:US
Practice Address - Phone:614-934-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6107152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist