Provider Demographics
NPI:1750421822
Name:GRONE, JOHN E (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:GRONE
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 1:134 EAST THIRD ST
Mailing Address - Street 2:PO BOX 159
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-0159
Mailing Address - Country:US
Mailing Address - Phone:419-692-0010
Mailing Address - Fax:419-692-4533
Practice Address - Street 1:134 EAST THIRD ST
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-0159
Practice Address - Country:US
Practice Address - Phone:419-692-0010
Practice Address - Fax:419-692-4533
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3030OH152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0265510Medicaid
OHT45944Medicare UPIN
OH0798170001Medicare NSC