Provider Demographics
NPI:1194414086
Name:ESHELMAN, SHERRIE
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:
Last Name:ESHELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 JONES RD
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44090-9507
Mailing Address - Country:US
Mailing Address - Phone:440-429-5864
Mailing Address - Fax:
Practice Address - Street 1:46440 US HWY RTE 20
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074
Practice Address - Country:US
Practice Address - Phone:440-774-6738
Practice Address - Fax:440-774-6740
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.016982-S152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty