Individual provider · Type 1 NPI

Samuel Jack Shroder, OD

Optometrist · Fairborn, OH

NPI number 1124982368 Active

Practice location

1790 Commerce Center Blvd
Fairborn, OH 45324-6358

Specialties and licenses

TaxonomyCodeLicense
Optometrist Primary 152W00000XOPT.007484 (OH)

Optometrist: Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional e…

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About NPI 1124982368

Samuel Jack Shroder, OD's National Provider Identifier is 1124982368, issued on Dec 11, 2025. The primary taxonomy on file is Optometrist (152W00000X), and the practice location is in Fairborn, OH. The record was last updated on May 18, 2026.