Provider Demographics
NPI:1275220527
Name:REPLOGLE, MERLE
Entity Type:Individual
Prefix:MR
First Name:MERLE
Middle Name:
Last Name:REPLOGLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 WAGNER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-2763
Mailing Address - Country:US
Mailing Address - Phone:937-547-9012
Mailing Address - Fax:937-547-9361
Practice Address - Street 1:1501 WAGNER AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-2763
Practice Address - Country:US
Practice Address - Phone:937-547-9012
Practice Address - Fax:937-547-9361
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.16973-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician