Provider Demographics
NPI:1528117249
Name:MERCER-DASHER, JULIE (OD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:MERCER-DASHER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N BECHTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2082
Mailing Address - Country:US
Mailing Address - Phone:937-324-5523
Mailing Address - Fax:937-324-0788
Practice Address - Street 1:900 N BECHTLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2082
Practice Address - Country:US
Practice Address - Phone:937-324-5523
Practice Address - Fax:937-324-0788
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5406152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU97521Medicare UPIN
OH4121232Medicare PIN