Provider Demographics
NPI:1851739783
Name:TAFLAN, NICHOLAS MATTHEW II (OD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MATTHEW
Last Name:TAFLAN
Suffix:II
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 1:1335 SOUTHGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-3015
Mailing Address - Country:US
Mailing Address - Phone:740-439-1098
Mailing Address - Fax:740-439-3165
Practice Address - Street 1:1335 SOUTHGATE PKWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-3015
Practice Address - Country:US
Practice Address - Phone:740-439-1098
Practice Address - Fax:740-439-3165
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6236152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist