Provider Demographics
NPI:1245286350
Name:OPHTHALMIC SURGEONS & CONSULTANTS OF OHIO INC
Entity type:Organization
Organization Name:OPHTHALMIC SURGEONS & CONSULTANTS OF OHIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:V
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-221-7464
Mailing Address - Street 1:262 NEIL AVE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2362
Mailing Address - Country:US
Mailing Address - Phone:614-221-7464
Mailing Address - Fax:614-884-0727
Practice Address - Street 1:262 NEIL AVE
Practice Address - Street 2:SUITE 430
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2362
Practice Address - Country:US
Practice Address - Phone:614-221-7464
Practice Address - Fax:614-884-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049318207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0247307Medicaid
OHOP9278811Medicare PIN