Provider Demographics
NPI:1841301587
Name:MEYER, ROBERT EARL (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EARL
Last Name:MEYER
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 1:302 LIMING FARM RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8360
Mailing Address - Country:US
Mailing Address - Phone:513-797-1260
Mailing Address - Fax:513-797-1262
Practice Address - Street 1:1815 E OHIO PIKE
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:OH
Practice Address - Zip Code:45102-2045
Practice Address - Country:US
Practice Address - Phone:513-797-1260
Practice Address - Fax:513-797-1262
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH5439152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH29785OtherSPECTERA
OH37320OtherAVESIS
OH926306OtherAMERIGROUP
OH53017OtherDAVIS VISION
OH2601367Medicaid
OHVO6467Medicare UPIN
OH2601367Medicaid