Provider Demographics
NPI:1033122049
Name:OPHTHALMIC CONSULTANTS AND SURGEONS OF CLEVELAND, INC.
Entity Type:Organization
Organization Name:OPHTHALMIC CONSULTANTS AND SURGEONS OF CLEVELAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAMPING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-291-9770
Mailing Address - Street 1:1611 S GREEN RD
Mailing Address - Street 2:SUITE 306A
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-4128
Mailing Address - Country:US
Mailing Address - Phone:216-291-9770
Mailing Address - Fax:216-291-0550
Practice Address - Street 1:1611 S GREEN RD
Practice Address - Street 2:SUITE 306A
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4128
Practice Address - Country:US
Practice Address - Phone:216-291-9770
Practice Address - Fax:216-291-0550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0994205Medicaid
OH0994205Medicaid