Provider Demographics
NPI:1659583862
Name:OPHTHALMIC SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:OPHTHALMIC SURGICAL ASSOCIATES
Other - Org Name:OPHTHALMIC SURGICAL ASSOCIATES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-874-5261
Mailing Address - Street 1:30 MEDICAL CENTER BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3955
Mailing Address - Country:US
Mailing Address - Phone:108-745-2616
Mailing Address - Fax:610-874-0318
Practice Address - Street 1:30 MEDICAL CENTER BLVD STE 104
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3955
Practice Address - Country:US
Practice Address - Phone:108-745-2616
Practice Address - Fax:610-874-0318
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPHTHALMIC SURGICAL ASSOCIATES,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-03
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA639529Medicare ID - Type Unspecified