Ethan Taylor Mengle (NPI# 1417449174, PAC ID# 8527313535) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1417449174 |
| PAC ID by PECOS | 8527313535 |
| Professional Enrollment ID | I20180615000251 |
| Full Name | Ethan Taylor Mengle |
| Organization Legal Name | WESTERN RESERVE EYE ASSOCIATES INC |
| Address |
5697 Darrow Rd Hudson OH 44236-4013 |
| Phone Number | 3304222020 |
| Gender | M |
| Medical School | UNIVERSITY ALABAMA BIRMINGHAM - SCHOOL OF OPTOMETRY |
| Graduation Year | 2018 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 1456391655 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1558 Akron Peninsula Rd, Akron, OH 44313-5154 | 3309224040 | WREA II LLC |
| 5697 Darrow Rd, Hudson, OH 44236-4013 | 3304222020 | WESTERN RESERVE EYE ASSOCIATES INC |
| 1155 State Route 303, Streetsboro, OH 44241-3969 | 3304222020 | WESTERN RESERVE EYE ASSOCIATES INC |
| Organization Legal Name | WESTERN RESERVE EYE ASSOCIATES INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter Schmid | Optometry | Western Reserve Eye Associates Inc | 1155 State Route 303, Streetsboro, OH 44241-3969 |
| William F Wiley | Ophthalmology | Western Reserve Eye Associates Inc | 1155 State Route 303, Streetsboro, OH 44241-3969 |
| Street Address |
5697 DARROW RD |
| City | HUDSON |
| State | OH |
| Zip | 44236-4013 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maria L Fyock | Nurse Practitioner | Rufus A Reuben Md Internal Medicine and Geriatrics Inc | 563 W Streetsboro St, Hudson, OH 44236-2050 |
| Richard H Warn | Podiatry | 200 Laurel Lake Dr, Hudson, OH 44236-2156 | |
| William B Keller | Optometry | Ohio Optometric Consultants Inc | 130 W Streetsboro St, Hudson, OH 44236-2720 |
| Rebecca J Ault | Chiropractic | Ault Chiropractic | 130 W Streetsboro St, Suite 2, Hudson, OH 44236-2757 |
| Robert J Ault | Chiropractic | Ault Chiropractic | 130 W Streetsboro St, Suite 2, Hudson, OH 44236-2757 |
| Kendall R. Hange | Chiropractic | Ault Chiropractic | 130 W Streetsboro St, Suite 2, Hudson, OH 44236-2757 |
| Holly J Timberlake | Psychologist, Clinical | 10 W Streetsboro St, Suite 105, Hudson, OH 44236-2851 | |
| Robert S Graves | Chiropractic | 46 Ravenna St, A4, Hudson, OH 44236-3058 | |
| Valerie Dawn Gregory | Nurse Practitioner | Great Lakes Practitioners LLC | 1212 Barlow Rd, Hudson, OH 44236-3713 |
| Deanna Caveslio | Nurse Practitioner | Northeast Ohio Practitioner LLC | 1212 Barlow Rd, Hudson, OH 44236-3713 |
| Find all physicians in zip 44236 | |||
| City | HUDSON |
| Zip Code | 44236 |
| Specialty | OPTOMETRY |
| City + Specialty | HUDSON + OPTOMETRY |
Please comment or provide details below to improve the information on Ethan Taylor Mengle.
| 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.