Provider Demographics
NPI:1346595956
Name:MEDICAL EYE ASSOCIATES OF CLEVELAND PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MEDICAL EYE ASSOCIATES OF CLEVELAND PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-759-9014
Mailing Address - Street 1:7840 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4301
Mailing Address - Country:US
Mailing Address - Phone:513-354-5808
Mailing Address - Fax:513-354-5774
Practice Address - Street 1:6800 ROCKSIDE RD
Practice Address - Street 2:UNIT A
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2383
Practice Address - Country:US
Practice Address - Phone:216-642-0068
Practice Address - Fax:216-328-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070424207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty