Provider Demographics
NPI:1972868271
Name:JERWERS, DARCIE LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:DARCIE
Middle Name:LYNN
Last Name:JERWERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DARCIE
Other - Middle Name:
Other - Last Name:LAUBENTHAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:102 PUTNAM PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-8657
Mailing Address - Country:US
Mailing Address - Phone:419-523-3937
Mailing Address - Fax:419-523-3944
Practice Address - Street 1:102 PUTNAM PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875
Practice Address - Country:US
Practice Address - Phone:419-523-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6131152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist