Provider Demographics
NPI:1225041031
Name:SLUSS, RONNIE J (OD)
Entity Type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:J
Last Name:SLUSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7593 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5407
Mailing Address - Country:US
Mailing Address - Phone:440-942-7714
Mailing Address - Fax:440-942-3901
Practice Address - Street 1:7593 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5407
Practice Address - Country:US
Practice Address - Phone:440-942-7714
Practice Address - Fax:440-942-3901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3271152W00000X
SC584152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH34-1372215-0135OtherNATIONAL VISION ADMINSTRA
OH000000131110OtherANTHEM
OH20250OtherSPECTERA
OH49614OtherDAVIS VISON
OH29114OtherSPECTERA
OH50142OtherDAVIS VISION
OHOH3271OtherEYEMED
OH50142OtherDAVIS VISION
OHT46825Medicare UPIN