Provider Demographics
NPI:1265471551
Name:PITTSER, JASON L (OD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:L
Last Name:PITTSER
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 1:7 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-2166
Mailing Address - Country:US
Mailing Address - Phone:740-335-1181
Mailing Address - Fax:740-335-1182
Practice Address - Street 1:7 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-2166
Practice Address - Country:US
Practice Address - Phone:740-335-1181
Practice Address - Fax:740-335-1182
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5143152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2201384OtherUNITED HEALTHCARE
OHDE215OtherMEDICARE RAILROAD
OH204403890001OtherMEDIACL MUTUAL
OH000000390796OtherBLUECROSS AND BLUESHIELD
OH9361561Medicare PIN
OH2201384OtherUNITED HEALTHCARE
OHU81256Medicare UPIN
OH4029355Medicare PIN
OHDE215OtherMEDICARE RAILROAD