Provider Demographics
NPI:1245528090
Name:MERCER IN-SIGHT LLC
Entity type:Organization
Organization Name:MERCER IN-SIGHT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:OTTE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-586-2909
Mailing Address - Street 1:PO BOX 629
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-0629
Mailing Address - Country:US
Mailing Address - Phone:419-586-2909
Mailing Address - Fax:419-586-8127
Practice Address - Street 1:706 E WAYNE ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1380
Practice Address - Country:US
Practice Address - Phone:419-586-2909
Practice Address - Fax:419-586-8127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0053275Medicaid