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NPI Code Detail

MEDICARE: DAVID PAUL YANIGLOS O.D.

MEDICARE: DAVID PAUL YANIGLOS 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
1152W00000XOptometrist3319T710OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000724230OTHERANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972520450
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID PAUL YANIGLOS O.D.
Provider Business Mailing Address
First Line : 518 WEST AVE
Second Line :
City : TALLMADGE
State : OH
Zip : 44278-2117
Country : US
Telephone Number : 330-630-9699
Fax Number : 330-633-7165
Provider Business Practice Location Address
First Line : 518 WEST AVE
Second Line :
City : TALLMADGE
State : OH
Zip : 44278-2117
Country : US
Telephone Number : 330-630-9699
Fax Number : 330-633-7165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 05/18/2012

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Directions to “ DAVID PAUL YANIGLOS O.D.” Practice Location

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