Provider Demographics
NPI:1912194788
Name:DRS. A & M ZOHN OPTOMETRIST, INC.
Entity Type:Organization
Organization Name:DRS. A & M ZOHN OPTOMETRIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZOHN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-726-1541
Mailing Address - Street 1:5426 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43611-2261
Mailing Address - Country:US
Mailing Address - Phone:419-726-1541
Mailing Address - Fax:419-726-7222
Practice Address - Street 1:5426 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-2261
Practice Address - Country:US
Practice Address - Phone:419-726-1541
Practice Address - Fax:419-726-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3448/T983152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2103922Medicaid
CJ2173Medicare PIN
OH2103922Medicaid
0293500001Medicare NSC
OH9348941Medicare PIN