Provider Demographics
NPI:1255398434
Name:MUSLER, JEFFREY IVAN (OD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:IVAN
Last Name:MUSLER
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 1:7507 CHRISTOPHER PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-0903
Mailing Address - Country:US
Mailing Address - Phone:704-544-7020
Mailing Address - Fax:
Practice Address - Street 1:4400 SHARON RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3531
Practice Address - Country:US
Practice Address - Phone:704-364-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-30
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1265152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0964AMedicaid
2466998Medicare PIN
NC0964AMedicaid