Provider Demographics
NPI:1609076744
Name:INSIGHT SURGERY & LASER CENTER, LLC
Entity Type:Organization
Organization Name:INSIGHT SURGERY & LASER CENTER, LLC
Other - Org Name:NORTHPOINTE ANESTHESIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MINNING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:740-454-1216
Mailing Address - Street 1:2935 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1487
Mailing Address - Country:US
Mailing Address - Phone:740-454-1216
Mailing Address - Fax:740-454-3830
Practice Address - Street 1:2935 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1487
Practice Address - Country:US
Practice Address - Phone:740-454-1216
Practice Address - Fax:740-454-3830
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE SURGERY ASSOCIATES OF ZANESVILLE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHIN9368901OtherMEDICARE PTAN