Jon E Mark (NPI# 1508869942, PAC ID# 5597800227) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1508869942 |
| PAC ID by PECOS | 5597800227 |
| Professional Enrollment ID | I20100305000743 |
| Full Name | Jon E Mark |
| Organization Legal Name | GROSSNICKLE EYE CENTER, INC. |
| Address |
2251 Dubois Dr Warsaw IN 46580-3212 |
| Phone Number | 5742692777 |
| Gender | M |
| Medical School | INDIANA UNIVERSITY - SCHOOL OF OPTOMETRY |
| Graduation Year | 1986 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 7810897758 |
| Number of Group Practice Members | 11 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150133 | KOSCIUSKO COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2251 Dubois Dr, Warsaw, IN 46580-3212 | 5742692777 | GROSSNICKLE EYE CENTER, INC. |
| Organization Legal Name | GROSSNICKLE EYE CENTER, INC. |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew C Ralstin | Ophthalmology | Grossnickle Eye Center, Inc. | 4330 Edison Lakes Pkwy, Suite A, Mishawaka, IN 46545-1446 |
| Bruce P Grossnickle | Ophthalmology | Grossnickle Eye Center, Inc. | 4330 Edison Lakes Pkwy A, Mishawaka, IN 46545-1446 |
| Ann Unijin Madden | Optometry | Grossnickle Eye Center, Inc. | 1510 Osolo Rd, Elkhart, IN 46514-4122 |
| Austin Ray Lifferth | Optometry | Grossnickle Eye Center, Inc. | 4330 Edison Lakes Pkwy, Suite A, Mishawaka, IN 46545-1446 |
| Allison A Pernic | Ophthalmology | Grossnickle Eye Center, Inc. | 1510 Osolo Rd, Elkhart, IN 46514-4122 |
| David F Ryser | Ophthalmology | Grossnickle Eye Center, Inc. | 4330 Edison Lakes Pkwy, Suite A, Mishawaka, IN 46545-1446 |
| Ann K Buikema-wiarda | Ophthalmology | Grossnickle Eye Center, Inc. | 4330 Edison Lakes Pkwy, Suite A, Mishawaka, IN 46545-1446 |
| Kristina Offerle | Optometry | Grossnickle Eye Center, Inc. | 1510 Osolo Rd, Elkhart, IN 46514-4122 |
| Christopher D Knight | Ophthalmology | Grossnickle Eye Center, Inc. | 4330 Edison Lakes Pkwy, Suite A, Mishawaka, IN 46545-1446 |
| Street Address |
2251 DUBOIS DR |
| City | WARSAW |
| State | IN |
| Zip | 46580-3212 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin D Day | Chiropractic | 118 W Market St, Warsaw, IN 46580-2812 | |
| Andrew S Yoder | Psychologist, Clinical | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Andrew Gerritt Smith | Psychiatry | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Richard E Ruhrold | Psychologist, Clinical | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Dawn Boughton | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Amber Joy Richards | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Kishore Sriram | Psychiatry | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Rhonda Irene Hall | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Kelly N Martinczak | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Julie A Moore | Clinical Social Worker | The Otis R Bowen Center for Human Services Inc | 850 N Harrison St, Warsaw, IN 46580-3163 |
| Find all physicians in zip 46580 | |||
| City | WARSAW |
| Zip Code | 46580 |
| Specialty | OPTOMETRY |
| City + Specialty | WARSAW + OPTOMETRY |
Please comment or provide details below to improve the information on Jon E Mark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.