Provider Demographics
NPI:1942394309
Name:EYE SURGERY CONSULTANTS INC.
Entity Type:Organization
Organization Name:EYE SURGERY CONSULTANTS INC.
Other - Org Name:REVISION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHUMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-525-3737
Mailing Address - Street 1:240 WEST COOK ROAD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907
Mailing Address - Country:US
Mailing Address - Phone:419-525-3737
Mailing Address - Fax:419-525-3740
Practice Address - Street 1:240 WEST COOK ROAD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907
Practice Address - Country:US
Practice Address - Phone:419-525-3737
Practice Address - Fax:419-525-3740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067416174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9358091Medicare ID - Type UnspecifiedGROUP NUMBER
OH5309000001Medicare NSC