Provider Demographics
NPI:1609921550
Name:BIERLY, JAMES A (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:BIERLY
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 1:5826 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7004
Mailing Address - Country:US
Mailing Address - Phone:937-428-9499
Mailing Address - Fax:937-428-9419
Practice Address - Street 1:5826 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-7004
Practice Address - Country:US
Practice Address - Phone:937-428-9499
Practice Address - Fax:937-428-9419
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0944536Medicaid
OHBI0707546Medicare ID - Type Unspecified
OH9321961Medicare ID - Type UnspecifiedGROUP NUMBER
OHBI0707543Medicare ID - Type Unspecified
OH0944536Medicaid