Provider Demographics
NPI:1528356136
Name:COMBS, ALICIA M (OD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:M
Last Name:COMBS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:BACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4883 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8057
Mailing Address - Country:US
Mailing Address - Phone:513-348-8225
Mailing Address - Fax:
Practice Address - Street 1:4883 PRINCETON ROAD
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-8057
Practice Address - Country:US
Practice Address - Phone:513-348-8225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6011152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist