Provider Demographics
NPI:1306095716
Name:ERNSTES, JEREMY MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:MICHAEL
Last Name:ERNSTES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 EAGLE LANE
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572
Mailing Address - Country:US
Mailing Address - Phone:513-232-2230
Mailing Address - Fax:513-232-2245
Practice Address - Street 1:7426 BEECHMONT AVENUE SUITE 209
Practice Address - Street 2:DR. DAVID S. TABELING & ASSOCIATES
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255
Practice Address - Country:US
Practice Address - Phone:513-232-2230
Practice Address - Fax:513-232-2245
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1741DT152W00000X
OH5790/T2704152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist