Provider Demographics
NPI:1053469122
Name:CINCINNATI EYE PHYSICIANS INC
Entity Type:Organization
Organization Name:CINCINNATI EYE PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-232-5550
Mailing Address - Street 1:7527 STATE RD STE A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-6408
Mailing Address - Country:US
Mailing Address - Phone:513-232-5550
Mailing Address - Fax:513-232-3510
Practice Address - Street 1:7527 STATE RD STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-6408
Practice Address - Country:US
Practice Address - Phone:513-232-5550
Practice Address - Fax:513-232-3510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35046479174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9284753Medicare ID - Type UnspecifiedMEDCIARE GROUP BATAVIA
OH9284752Medicare ID - Type UnspecifiedGROUP NUMBER