Provider Demographics
NPI:1487663639
Name:SPOHN, ERNEST SIDNEY I (OD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:SIDNEY
Last Name:SPOHN
Suffix:I
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2925 GLENDALE AVE
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2684
Mailing Address - Country:US
Mailing Address - Phone:419-380-8769
Mailing Address - Fax:419-380-8921
Practice Address - Street 1:2925 GLENDALE AVE
Practice Address - Street 2:VISION CENTER
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2684
Practice Address - Country:US
Practice Address - Phone:419-380-8769
Practice Address - Fax:419-380-8921
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3092P230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist