Mellott, Derek

Mellott, Derek is an individual health care provider with primary practice located at 8277 Market St Suite B, Boardman OH 44512-6246. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mellott, Derek can be contacted via phone (330) 726-5544.

Contact Information

Primary practice address
8277 Market St Suite B Boardman OH 44512-6246
Phone: (330) 726-5544
Fax: (330) 758-3874
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3951 Ohio

Profile Details

NPI number 1982624870
LBN Legal business name Mellott, Derek
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Dec 28th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982624870 NPPES
Ohio Other 2201047 UNITED HEALTH CARE
Ohio MEDICAID 0691381 UNITED HEALTH CARE
Ohio Other 410035075 UNITED HEALTH CARE
Ohio Other 341605571028 UNITED HEALTH CARE
Ohio Other 000000226430 UNITED HEALTH CARE

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