Provider Demographics
NPI:1174688238
Name:SOUTHERN OHIO EYE PHYSICIANS,INC.
Entity Type:Organization
Organization Name:SOUTHERN OHIO EYE PHYSICIANS,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHAMOLOGY
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MELVIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-861-8300
Mailing Address - Street 1:3120 BURNET AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3091
Mailing Address - Country:US
Mailing Address - Phone:513-861-8300
Mailing Address - Fax:
Practice Address - Street 1:3120 BURNET AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3091
Practice Address - Country:US
Practice Address - Phone:513-861-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH51997207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty