Provider Demographics
NPI:1073654273
Name:KUNESH EYE CENTER, INC
Entity Type:Organization
Organization Name:KUNESH EYE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUNESH-PART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-298-1703
Mailing Address - Street 1:2601 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1634
Mailing Address - Country:US
Mailing Address - Phone:937-298-1703
Mailing Address - Fax:937-298-6344
Practice Address - Street 1:2601 FAR HILLS AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45419-1634
Practice Address - Country:US
Practice Address - Phone:937-298-1703
Practice Address - Fax:937-298-6344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0818146Medicaid
OH0818146Medicaid