Provider Demographics
NPI:1184638173
Name:EYE PHYSICIANS & SURGEONS OF ATHENS INC.
Entity Type:Organization
Organization Name:EYE PHYSICIANS & SURGEONS OF ATHENS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MCADOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-592-4461
Mailing Address - Street 1:75 HOSPITAL DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701
Mailing Address - Country:US
Mailing Address - Phone:740-592-4461
Mailing Address - Fax:740-592-5899
Practice Address - Street 1:75 HOSPITAL DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701
Practice Address - Country:US
Practice Address - Phone:740-592-4461
Practice Address - Fax:740-592-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0871070Medicaid
OH0871070Medicaid
OH9933901Medicare PIN