Provider Demographics
NPI:1497032833
Name:NORTHERN OHIO EYE CONSULTANTS, INC
Entity Type:Organization
Organization Name:NORTHERN OHIO EYE CONSULTANTS, INC
Other - Org Name:CLEVELAND EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-621-6132
Mailing Address - Street 1:7001 S EDGERTON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-4206
Mailing Address - Country:US
Mailing Address - Phone:440-526-1974
Mailing Address - Fax:440-740-0662
Practice Address - Street 1:1180 E BROAD ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-6306
Practice Address - Country:US
Practice Address - Phone:440-366-6969
Practice Address - Fax:440-366-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5460T2372152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty