Individual
DR. EDWARD J. JAGELA
Active
Individual
DR. EDWARD J. JAGELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., F.A.A.O.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4201/T497
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000213650
ANTHEM BC/BS
OH
01
—
0007520120
AETNA
OH
01
—
001720035
MOUNTAIN STATE BC/BS
OH
05
—
0149838001
—
WV
01
—
0898953
CARESOURCE
OH
05
—
0898953
—
OH
01
—
1068565
BUR OF WC (BRICKSTREET)
WV
01
—
4201T497
MEDICAL MUTUAL
OH
Enumeration date
09/13/2005
Last updated
05/16/2019
Update your record
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