Provider Demographics
NPI:1407164999
Name:WING EYECARE, INC.
Entity Type:Organization
Organization Name:WING EYECARE, INC.
Other - Org Name:WING EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-921-8433
Mailing Address - Street 1:3850 PAXTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-2399
Mailing Address - Country:US
Mailing Address - Phone:513-533-0031
Mailing Address - Fax:513-533-0086
Practice Address - Street 1:3850 PAXTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45209-2399
Practice Address - Country:US
Practice Address - Phone:513-533-0031
Practice Address - Fax:513-533-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9306052OtherMEDICARE - OFFICE #
OH1325810015Medicare NSC