John C Schertzinger, O.D.
Individual provider Active NPI Optometrist · Owensboro, KY
NPI 1932108487 · NPPES record last updated Dec 27, 2007
Key facts
- NPI
- 1932108487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 07210T (KY)
- Practice address
- 221 Allen St
Owensboro, KY 42303-4139 - Phone
- (270) 685-4966
- Fax
- (270) 686-8058
- NPI assigned
- Jul 18, 2005
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07210T | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aeg Kentucky Professional, PLLC | Optometrist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 07210T | KY | Yes |
Addresses
Primary practice location
221 Allen St
Owensboro, KY 42303-4139
Mailing address
221 Allen St
Owensboro, KY 42303-4139
Phone (270) 685-4966
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77007219 | Medicaid | KY | |
| 000000049821 | Other | KY | ANTHEM BCBS |
Other providers in Owensboro, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2007. 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.