Provider Demographics
NPI:1134128861
Name:MACHER, JERRY IRVING (MD)
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:IRVING
Last Name:MACHER
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 1:6880 W SNOWVILLE RD
Mailing Address - Street 2:STE 215
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-3254
Mailing Address - Country:US
Mailing Address - Phone:440-656-5050
Mailing Address - Fax:
Practice Address - Street 1:800 MCKINLEY AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-2463
Practice Address - Country:US
Practice Address - Phone:330-452-8884
Practice Address - Fax:330-452-2404
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-041094207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0432268Medicaid
OH0432268Medicaid
MA0480104Medicare ID - Type Unspecified