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Individual

DR. NATHAN R BJORK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
315 N BREIEL BLVD, MIDDLETOWN, OH 45042-3868
(513) 424-0339
(513) 424-4910
Mailing address
315 N BREIEL BLVD, MIDDLETOWN, OH 45042-3868
(513) 424-0339
(513) 424-4910

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5104 T2003
OH
174400000X
Specialist
5104T2003
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000019393
CEI BCBS
01
000000270789
MEC BCBS
OH
01
180044530
RAILROAD MEDICARE
OH
05
200320880
IN
05
2226308
OH
01
651160826029
CARESOURCE
OH
05
77000313
KY
Enumeration date
05/01/2006
Last updated
02/15/2012
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