Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 35034107D | OH |
NPI | 1346245743 |
---|---|
Provider Name | Dr. John W Drury |
First Address | Sandusky, OH 44870-5130 |
Second Address | Sandusky, OH 44870-5130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000130804 | BCBS (01) | OH |
01554 | PARAMOUNT (01) | OH |
0226393 | (05) | OH |
0529590001 | DMERC (01) | OH |
08002 | VANTAGE (01) | OH |
0C01823 | NATIONWIDE (01) | OH |
341349521001 | MMOH (01) | OH |
4093125 | AETNA (01) | OH |
A73870 | (02) | OH |