Provider Demographics
NPI:1063810299
Name:DR CLAFFIE AND ASSOCIATES
Entity type:Organization
Organization Name:DR CLAFFIE AND ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-683-9710
Mailing Address - Street 1:9998 KINGS AUTO MALL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-8234
Mailing Address - Country:US
Mailing Address - Phone:513-683-9710
Mailing Address - Fax:513-683-7965
Practice Address - Street 1:2130 MALL ROAD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1494
Practice Address - Country:US
Practice Address - Phone:859-525-8810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1967DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9390111OtherMEDICARE PTAN, GROUP OH