Individual
DR. JON ERIC NOLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001572
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
401689
HIGHMARK BLUE SHIELD
—
01
—
410002052
TRAVELERS MEDICARE
—
Enumeration date
02/10/2006
Last updated
05/06/2011
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