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General NPI Number Information
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NPI Number | 1144422361
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Entity Type | Organization
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Legal Business Name | EDWARD J JAGELA OD FAAO
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 4100 JOHNSON RD STE 204
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2365
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Country | US
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Telephone | 740-283-3937
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Fax | 740-283-1858
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Provider Business Mailing Address
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Address Line | 4100 JOHNSON RD STE 204
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2365
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Country | US
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Telephone | 740-283-3937
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Fax | 740-283-1858
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Authorized Official
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Title or Position | OPTOMETRIST OWNER
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Name | DR. EDWARD JAGELA
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Credential | OD
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Telephone | 740-283-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4201T497
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License Number State | OH
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