Provider Demographics
NPI:1255354916
Name:WERSTLER, TODD DAVID (OD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:DAVID
Last Name:WERSTLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MASSILLON MARKETPLACE DR SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-2018
Mailing Address - Country:US
Mailing Address - Phone:330-834-0500
Mailing Address - Fax:330-494-4633
Practice Address - Street 1:1 MASSILLON MARKETPLACE DR SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-2018
Practice Address - Country:US
Practice Address - Phone:330-834-1364
Practice Address - Fax:330-494-4633
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3506152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0197250001OtherDMEPOS
OH0444120Medicaid
OH0197250001OtherDMEPOS