Provider Demographics
NPI:1912963570
Name:SPEESLER, PAUL FRANKLIN (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANKLIN
Last Name:SPEESLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:FRANKLIN
Other - Last Name:SPEESLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1925 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-3534
Mailing Address - Country:US
Mailing Address - Phone:215-854-0441
Mailing Address - Fax:215-568-0661
Practice Address - Street 1:2801 N. 22ND. ST.
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132
Practice Address - Country:US
Practice Address - Phone:215-226-0355
Practice Address - Fax:215-226-1056
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET008973152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT72744Medicare UPIN