MEDICARE: RICHARD J HERR 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	2792 T815	OH

General Provider Information

NPI Number	:	1467531020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD J HERR O.D.

Provider Business Mailing Address
First Line	:	123 W SANDUSKY ST
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-3215
Country	:	US
Telephone Number	:	419-422-3472
Fax Number	:	419-422-3786

Provider Business Practice Location Address
First Line	:	123 W SANDUSKY ST
Second Line	:
City	:	FINDLAY
State	:	OH
Zip	:	45840-3215
Country	:	US
Telephone Number	:	419-422-3472
Fax Number	:	419-422-3786

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/08/2007

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