MEDICARE: DR. GAIL SANDERSON 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	5414	OH

General Provider Information

NPI Number	:	1386641264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL SANDERSON OD

Provider Business Mailing Address
First Line	:	5426 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-2261
Country	:	US
Telephone Number	:	419-726-1541
Fax Number	:	419-726-7222

Provider Business Practice Location Address
First Line	:	5198 N SUMMIT ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43611-2748
Country	:	US
Telephone Number	:	419-726-1541
Fax Number	:	419-726-7222

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	02/11/2020

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Directions to “ DR. GAIL SANDERSON OD” Practice Location

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