Provider Demographics
NPI:1003842790
Name:OHIO VALLEY EYE PHYSICIANS & SURGEONS PLLC
Entity Type:Organization
Organization Name:OHIO VALLEY EYE PHYSICIANS & SURGEONS PLLC
Other - Org Name:OHIO VALLEY EYE PHYSICIANS & SURGEONS, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-428-3500
Mailing Address - Street 1:418 GRAND PARK DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26105-4000
Mailing Address - Country:US
Mailing Address - Phone:304-428-3500
Mailing Address - Fax:304-422-7900
Practice Address - Street 1:418 GRAND PARK DR
Practice Address - Street 2:SUITE 315
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26105-4000
Practice Address - Country:US
Practice Address - Phone:304-428-3500
Practice Address - Fax:304-422-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00449568OtherMOUNTAIN STATE BLUE CROSS
WV0008970-000Medicaid
CL8195OtherRAILROAD MEDICARE
OH2797773Medicaid
OH2797773Medicaid