Provider Demographics
NPI:1033440870
Name:DR. JASON T. MCCAIN O.D. P.C.
Entity Type:Organization
Organization Name:DR. JASON T. MCCAIN O.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-848-2243
Mailing Address - Street 1:6244 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7024
Mailing Address - Country:US
Mailing Address - Phone:937-848-2243
Mailing Address - Fax:937-848-2498
Practice Address - Street 1:6244 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-7024
Practice Address - Country:US
Practice Address - Phone:937-848-2243
Practice Address - Fax:937-848-2498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4952/T1822152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty