Provider Demographics
NPI:1154404804
Name:HARTMAN, DAWN LYNETTE (OD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LYNETTE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3728 KELLEN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6022
Mailing Address - Country:US
Mailing Address - Phone:614-898-1922
Mailing Address - Fax:
Practice Address - Street 1:4012 EASTON STA
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-6080
Practice Address - Country:US
Practice Address - Phone:614-476-2586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5016152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist