Provider Demographics
NPI:1225097884
Name:PARSCHAUER, KENNETH E (DO)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:E
Last Name:PARSCHAUER
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:PO BOX 2238
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871
Mailing Address - Country:US
Mailing Address - Phone:419-625-6181
Mailing Address - Fax:419-625-7493
Practice Address - Street 1:2600 HAYES AVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870
Practice Address - Country:US
Practice Address - Phone:419-625-6181
Practice Address - Fax:419-625-7493
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003201207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0569264Medicaid
PA0553362Medicare ID - Type Unspecified
OH0569264Medicaid