Provider Demographics
NPI:1023187630
Name:LEE EYE CENTER INC
Entity Type:Organization
Organization Name:LEE EYE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-758-0900
Mailing Address - Street 1:8135 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-6244
Mailing Address - Country:US
Mailing Address - Phone:330-758-0900
Mailing Address - Fax:330-758-2790
Practice Address - Street 1:8135 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6244
Practice Address - Country:US
Practice Address - Phone:330-758-0900
Practice Address - Fax:330-758-2790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0323290001Medicare NSC
OH9234131Medicare PIN
OHCM3787Medicare PIN