Provider Demographics
NPI:1306195995
Name:DR. ERIC E. NEADER, INC.
Entity Type:Organization
Organization Name:DR. ERIC E. NEADER, INC.
Other - Org Name:OPTIC NERVE POLARIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEADER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-885-3937
Mailing Address - Street 1:1500 POLARIS PARKWAY
Mailing Address - Street 2:SUITE # 1234
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240
Mailing Address - Country:US
Mailing Address - Phone:614-885-3937
Mailing Address - Fax:614-885-8181
Practice Address - Street 1:1500 POLARIS PARKWAY
Practice Address - Street 2:SUITE # 1234
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240
Practice Address - Country:US
Practice Address - Phone:614-885-3937
Practice Address - Fax:614-885-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5499/T2411152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty