Provider Demographics
NPI:1336251057
Name:NEPTUNE, CHRISTOPHER BURWELL (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BURWELL
Last Name:NEPTUNE
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 1:7959 TRINITY SHORE CIR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45044-8319
Mailing Address - Country:US
Mailing Address - Phone:513-779-2653
Mailing Address - Fax:513-923-9907
Practice Address - Street 1:10224 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-4904
Practice Address - Country:US
Practice Address - Phone:513-923-9904
Practice Address - Fax:513-923-9907
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4432/T1025152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4102543OtherMEDICARE PTAN
OH4102543OtherMEDICARE PTAN
OH4102543Medicare PIN