Provider Demographics
NPI:1053641100
Name:ZAHLER, JONATHAN DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DAVID
Last Name:ZAHLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 BENEDICT AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-8892
Mailing Address - Country:US
Mailing Address - Phone:419-668-3295
Mailing Address - Fax:419-668-8861
Practice Address - Street 1:278 BENEDICT AVE
Practice Address - Street 2:ST. #300
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2399
Practice Address - Country:US
Practice Address - Phone:419-668-3295
Practice Address - Fax:419-668-8861
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009858207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3111180Medicaid
PA183992FVUMedicare PIN
OH3111180Medicaid