Provider Demographics
NPI:1609956846
Name:DELAWARE EYE SURGEONS PA
Entity Type:Organization
Organization Name:DELAWARE EYE SURGEONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:S.
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-993-1300
Mailing Address - Street 1:2710 CENTERVILLE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1644
Mailing Address - Country:US
Mailing Address - Phone:302-993-1300
Mailing Address - Fax:302-993-1400
Practice Address - Street 1:2710 CENTERVILLE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1644
Practice Address - Country:US
Practice Address - Phone:302-993-1300
Practice Address - Fax:302-993-1400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1991027605152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty