Provider Demographics
NPI:1275683005
Name:EYE SERVICES LLC
Entity Type:Organization
Organization Name:EYE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIA-HUNG
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-383-3277
Mailing Address - Street 1:630 W MAIN ST
Mailing Address - Street 2:MAIL 18
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-2170
Mailing Address - Country:US
Mailing Address - Phone:937-383-3277
Mailing Address - Fax:937-283-9146
Practice Address - Street 1:671 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-2124
Practice Address - Country:US
Practice Address - Phone:937-383-3277
Practice Address - Fax:937-283-9146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH35075663C207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2269718Medicaid
OHH51910Medicare UPIN
OH9334361Medicare PIN