Provider Demographics
NPI:1629117221
Name:MUIRFIELD EYE CARE CENTER, INC.
Entity Type:Organization
Organization Name:MUIRFIELD EYE CARE CENTER, INC.
Other - Org Name:JOHN F. FANNING, O.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:FANNING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:614-793-8440
Mailing Address - Street 1:6105 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9000
Mailing Address - Country:US
Mailing Address - Phone:614-793-8440
Mailing Address - Fax:614-793-8383
Practice Address - Street 1:6105 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-9000
Practice Address - Country:US
Practice Address - Phone:614-793-8440
Practice Address - Fax:614-793-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3707152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOH3707OtherEYEMED
OH299624571-001OtherMEDICAL MUTUAL
OH23837OtherSPECTERA
OH000000119325OtherBLUE CROSS BLUE SHILED
OH0809637OtherAETNA
OH2200157OtherUNITED HEALTH CARE
OH000000119325OtherBLUE CROSS BLUE SHILED
OH000000119325OtherBLUE CROSS BLUE SHILED
OH0809637OtherAETNA
OHOH3707OtherEYEMED