Provider Demographics
NPI:1083795892
Name:MOUSER, JAMES GARRET (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:GARRET
Last Name:MOUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 GATEWAY CIR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8650
Mailing Address - Country:US
Mailing Address - Phone:614-274-2020
Mailing Address - Fax:614-272-8059
Practice Address - Street 1:1600 GATEWAY CIR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8650
Practice Address - Country:US
Practice Address - Phone:614-274-2020
Practice Address - Fax:614-272-8059
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-089404207W00000X
OH35.089404207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2726107Medicaid
OH2726107Medicaid
OH73336Medicare UPIN
OH9191664Medicare PIN