Provider Demographics
NPI:1831230002
Name:SPANGLER, LOIS A (OD)
Entity type:Individual
Prefix:DR
First Name:LOIS
Middle Name:A
Last Name:SPANGLER
Suffix:
Gender:F
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 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-1761
Mailing Address - Country:US
Mailing Address - Phone:419-690-0010
Mailing Address - Fax:419-692-4533
Practice Address - Street 1:134 E 3RD ST
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-1761
Practice Address - Country:US
Practice Address - Phone:419-690-0010
Practice Address - Fax:419-692-4533
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4625OH152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND000000125822OtherANTHEM
OH0157888Medicaid
OHU55332Medicare UPIN
OH0157888Medicaid