Provider Demographics
NPI:1033201553
Name:WESLEY J HARNISH MD
Entity Type:Organization
Organization Name:WESLEY J HARNISH MD
Other - Org Name:EYE SURGICAL & MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-899-2020
Mailing Address - Street 1:550 S CLEVELAND AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8958
Mailing Address - Country:US
Mailing Address - Phone:614-899-2020
Mailing Address - Fax:614-899-2454
Practice Address - Street 1:550 S CLEVELAND AVE
Practice Address - Street 2:SUITE E
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8958
Practice Address - Country:US
Practice Address - Phone:614-899-2020
Practice Address - Fax:614-899-2454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5865152W00000X
OH35053294207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHCA8572OtherRAILROAD GROUP #
OHCA8572OtherRAILROAD GROUP #
6650250001Medicare NSC