MEDICARE: DR. JOHN M POLING OD

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	1368	IN

General Provider Information

NPI Number	:	1447222872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M POLING OD

Provider Business Mailing Address
First Line	:	2656 EAST SECOND STREET
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401
Country	:	US
Telephone Number	:	812-339-6131
Fax Number	:	812-339-6161

Provider Business Practice Location Address
First Line	:	2656 EAST SECOND STREET
Second Line	:
City	:	BLOOMINGTON
State	:	IN
Zip	:	47401
Country	:	US
Telephone Number	:	812-339-6131
Fax Number	:	812-339-6161

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/15/2026

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