Provider Demographics
NPI:1083017644
Name:EYE CENTERS OF CLEVELAND, INC
Entity Type:Organization
Organization Name:EYE CENTERS OF CLEVELAND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ARISTOTLE
Authorized Official - Last Name:MARKAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-581-6111
Mailing Address - Street 1:12000 MCCRACKEN RD STE 215
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2933
Mailing Address - Country:US
Mailing Address - Phone:216-581-6111
Mailing Address - Fax:
Practice Address - Street 1:12000 MCCRACKEN RD STE 215
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2933
Practice Address - Country:US
Practice Address - Phone:216-581-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35097311207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH014111Medicare PIN