Provider Demographics
NPI:1467466631
Name:PIERSOL, JAMES J (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:PIERSOL
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 1:5585 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-4825
Mailing Address - Country:US
Mailing Address - Phone:814-725-0473
Mailing Address - Fax:
Practice Address - Street 1:2203 W 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4501
Practice Address - Country:US
Practice Address - Phone:814-838-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000664152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013062200002Medicaid
PA0013062200002Medicaid
PA120830Medicare ID - Type Unspecified