Provider Demographics
NPI:1114181021
Name:TUTTLE EYE ASSOCIATES INC
Entity Type:Organization
Organization Name:TUTTLE EYE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:DEMETRIOS
Authorized Official - Last Name:POULOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-724-0396
Mailing Address - Street 1:2859 ACARIE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-6198
Mailing Address - Country:US
Mailing Address - Phone:440-724-0396
Mailing Address - Fax:
Practice Address - Street 1:5043 TUTTLE CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1511
Practice Address - Country:US
Practice Address - Phone:440-724-0396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-10
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4581152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty