MEDICARE: DR. JONATHAN DOUGLAS TSCHANZ 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	3274	OH

General Provider Information

NPI Number	:	1164597266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN DOUGLAS TSCHANZ O.D.

Provider Business Mailing Address
First Line	:	1265 W MARKET ST
Second Line	:
City	:	GERMANTOWN
State	:	OH
Zip	:	45327-1715
Country	:	US
Telephone Number	:	937-855-4121
Fax Number	:	937-855-1041

Provider Business Practice Location Address
First Line	:	1265 W MARKET ST
Second Line	:
City	:	GERMANTOWN
State	:	OH
Zip	:	45327-1715
Country	:	US
Telephone Number	:	937-855-4121
Fax Number	:	937-855-1041

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

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	12/01/2023

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