Provider Demographics
NPI:1093706731
Name:CLOEPFIL, JAMES O (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:O
Last Name:CLOEPFIL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:501 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-1963
Mailing Address - Country:US
Mailing Address - Phone:712-246-2726
Mailing Address - Fax:
Practice Address - Street 1:505 W SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-1705
Practice Address - Country:US
Practice Address - Phone:712-246-1786
Practice Address - Fax:712-246-1182
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01768152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1093706731OtherBLOCK VISION
24360OtherMIDLANDS CHOICE
IA07361OtherBCBS
NE100249544-00Medicaid
IA2050153Medicaid
930455OtherEYEMED
22-00003OtherUHC
IA2050153Medicaid
410041719Medicare PIN
1093706731OtherBLOCK VISION
IAT71272Medicare UPIN