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Contact Information

MARK A BIDLACK, OD
1183 WESTWOOD DRIVE
VAN WERT, OH45891
 Phone: 419-238-9244
 Fax: 419-238-4695
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARK A BIDLACK · (Male)

NPI # 1356312888
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/01/2006
Last updated 02/07/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 3921/T1214
  • OH Medicaid 2445296
  • OH Other 000000314744 BCBS
  • OH Other 61143605100 BWC
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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