James William Mershon, OD
Individual provider Active NPI Optometrist · Caldwell, OH
NPI 1043390867 · NPPES record last updated May 23, 2011
Key facts
- NPI
- 1043390867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3554T948 (OH)
- Practice address
- 402 Cumberland St
Caldwell Vision Centre
Caldwell, OH 43724-1234 - Phone
- (740) 732-4620
- Fax
- (740) 732-7179
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3554 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary E Rex | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3554T948 | OH | Yes |
Addresses
Primary practice location
402 Cumberland St
Caldwell Vision Centre
Caldwell, OH 43724-1234
Mailing address
402 Cumberland St
Caldwell, OH 43724
Phone (740) 732-4620
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0464162 | Medicaid | OH | |
| 0529025 | Other | OH | MEDICARE PTAN |
Other names
- Dr. James Mershon
Other providers in Caldwell, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.