Provider Demographics
NPI:1407846215
Name:DAVIS EYE CENTER, INC
Entity Type:Organization
Organization Name:DAVIS EYE CENTER, INC
Other - Org Name:THE CENTER FOR SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-923-5676
Mailing Address - Street 1:789 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-1045
Mailing Address - Country:US
Mailing Address - Phone:330-923-5676
Mailing Address - Fax:330-572-2450
Practice Address - Street 1:789 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1045
Practice Address - Country:US
Practice Address - Phone:330-923-5676
Practice Address - Fax:330-572-2450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH259261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2060531Medicaid
0000000201574OtherANTHEM
490003256OtherRAILROAD MEDICARE
1023317OtherAETNA
0000000201574OtherANTHEM
1023317OtherAETNA