MEDICARE: DR. RONNIE J. SLUSS O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3271	OH
2	152W00000X	Optometrist	584	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34-1372215-0135	OTHER	OH	NATIONAL VISION ADMINSTRA
2	000000131110	OTHER	OH	ANTHEM
3	20250	OTHER	OH	SPECTERA
4	49614	OTHER	OH	DAVIS VISON
5	29114	OTHER	OH	SPECTERA
6	50142	OTHER	OH	DAVIS VISION
7	OH3271	OTHER	OH	EYEMED

General Provider Information

NPI Number	:	1225041031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONNIE J. SLUSS O.D.

Provider Business Mailing Address
First Line	:	7593 MENTOR AVE
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-5407
Country	:	US
Telephone Number	:	440-942-7714
Fax Number	:	440-942-3901

Provider Business Practice Location Address
First Line	:	7593 MENTOR AVE
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-5407
Country	:	US
Telephone Number	:	440-942-7714
Fax Number	:	440-942-3901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. RONNIE J. SLUSS O.D.” Practice Location

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