Provider Demographics
NPI:1417150400
Name:MARK S VOSLER
Entity Type:Organization
Organization Name:MARK S VOSLER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:VOSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:937-456-8334
Mailing Address - Street 1:345 KAYLER RD
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-9267
Mailing Address - Country:US
Mailing Address - Phone:937-456-6773
Mailing Address - Fax:937-456-8335
Practice Address - Street 1:450B WASHINGTON JACKSON RD
Practice Address - Street 2:STE 108
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-7601
Practice Address - Country:US
Practice Address - Phone:937-456-8332
Practice Address - Fax:937-456-8335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH066635OtherAETNA
OH301529179OtherMEDICAL MUTUAL
OH0427881Medicaid
OH000000177148OtherANTHEM BLUE CROSS BLUE SH
OHQMP000003334203OtherMOLINA
OH02120397OtherUNITED HEALTHCARE
9370331OtherMEDICARE PTAN
OH2874242Medicaid
OH791126460OtherRAILROAD PALMETTO GBA
OHE00657Medicare UPIN