Provider Demographics
NPI:1295846137
Name:ROHLER, STEFANIE L (OD)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:L
Last Name:ROHLER
Suffix:
Gender:F
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:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:GRUNDY CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50638-0187
Mailing Address - Country:US
Mailing Address - Phone:319-824-6380
Mailing Address - Fax:319-824-2306
Practice Address - Street 1:509 G AVE
Practice Address - Street 2:
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-1651
Practice Address - Country:US
Practice Address - Phone:319-824-6380
Practice Address - Fax:319-824-2306
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2019152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2101832Medicaid
IA410030762OtherRAILROAD MEDICARE
IA410030762OtherRAILROAD MEDICARE
IA52335Medicare PIN
IA1039760001Medicare NSC