Provider Demographics
NPI:1942350913
Name:VISUALEYES, INC.
Entity Type:Organization
Organization Name:VISUALEYES, INC.
Other - Org Name:BEAVERCREEK VISION CENTRER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-258-1515
Mailing Address - Street 1:3085 WOODMAN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-1159
Mailing Address - Country:US
Mailing Address - Phone:937-258-1515
Mailing Address - Fax:937-258-8790
Practice Address - Street 1:1370 N FAIRFIELD RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2675
Practice Address - Country:US
Practice Address - Phone:937-426-2212
Practice Address - Fax:937-426-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1283730002Medicare ID - Type Unspecified
OH1283730001Medicare ID - Type Unspecified