Provider Demographics
NPI:1568467496
Name:SHERER, JERRY L (OD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:L
Last Name:SHERER
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:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-0760
Mailing Address - Country:US
Mailing Address - Phone:406-338-6140
Mailing Address - Fax:406-338-6128
Practice Address - Street 1:HOSPITAL HILL
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-0760
Practice Address - Country:US
Practice Address - Phone:406-338-6140
Practice Address - Fax:406-338-6128
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT404152W00000X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT8HZ29YMedicare ID - Type Unspecified
MTT89258Medicare UPIN