Provider Demographics
NPI:1720613136
Name:NORTHERN OHIO EYE CONSULTANTS INC
Entity Type:Organization
Organization Name:NORTHERN OHIO EYE CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-540-4766
Mailing Address - Street 1:PO BOX 14000
Mailing Address - Street 2:ATTN#14674R
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4033
Mailing Address - Country:US
Mailing Address - Phone:800-875-0300
Mailing Address - Fax:
Practice Address - Street 1:36991 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-4060
Practice Address - Country:US
Practice Address - Phone:440-717-0591
Practice Address - Fax:440-717-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2410395Medicaid