Provider Demographics
NPI:1376607093
Name:MEYER, DEVON L (OD)
Entity Type:Individual
Prefix:DR
First Name:DEVON
Middle Name:L
Last Name:MEYER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:309 EATON LEWISBURG RD
Mailing Address - Street 2:PO BOX 117
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-1104
Mailing Address - Country:US
Mailing Address - Phone:937-456-5559
Mailing Address - Fax:937-456-1089
Practice Address - Street 1:309 EATON LEWISBURG RD
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1104
Practice Address - Country:US
Practice Address - Phone:937-456-5559
Practice Address - Fax:937-456-1089
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2885 T564152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0354480001Medicare NSC