Provider Demographics
NPI:1174529978
Name:DANIEL, WILLIAM ROHL (OD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROHL
Last Name:DANIEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 MONROE AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663
Mailing Address - Country:US
Mailing Address - Phone:330-602-5339
Mailing Address - Fax:
Practice Address - Street 1:CHINLE HOSPITAL EYE CLINIC
Practice Address - Street 2:PO DRAWER PH
Practice Address - City:CHINLE
Practice Address - State:AZ
Practice Address - Zip Code:86503
Practice Address - Country:US
Practice Address - Phone:928-674-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP-100042152W00000X
OH5299 T2208152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU97358Medicare UPIN