Individual
DR. BRICE RUSSELL MUSSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
102 DR. THATYE DRIVE, OTTAWA, OH 45875
(419) 538-6273
(419) 538-7273
Mailing address
PO BOX 20, GLANDORF, OH 45848-0020
(419) 538-6273
(419) 538-7273
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2916
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000140764
ANTHEM BCBS
OH
05
—
0179266
—
OH
01
—
0363830001
ADMINASTAR
OH
01
—
410037333
RAILROAD MEDICARE
OH
Enumeration date
06/24/2005
Last updated
04/13/2011
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