MEDICARE: DR. JOHN E GRONE 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	3030OH	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750421822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E GRONE O.D.

Provider Business Mailing Address
First Line	:	134 EAST THIRD ST
Second Line	:	PO BOX 159
City	:	DELPHOS
State	:	OH
Zip	:	45833-0159
Country	:	US
Telephone Number	:	419-692-0010
Fax Number	:	419-692-4533

Provider Business Practice Location Address
First Line	:	134 EAST THIRD ST
Second Line	:
City	:	DELPHOS
State	:	OH
Zip	:	45833-0159
Country	:	US
Telephone Number	:	419-692-0010
Fax Number	:	419-692-4533

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	10/03/2008

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Directions to “ DR. JOHN E GRONE O.D.” Practice Location

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