Provider Demographics
NPI:1912955741
Name:EYE SURGERY ASSOCIATES OF ZANESVILLE, INC.
Entity Type:Organization
Organization Name:EYE SURGERY ASSOCIATES OF ZANESVILLE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MINNING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:740-454-1216
Mailing Address - Street 1:2935 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1487
Mailing Address - Country:US
Mailing Address - Phone:740-454-1216
Mailing Address - Fax:740-454-3830
Practice Address - Street 1:2935 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1487
Practice Address - Country:US
Practice Address - Phone:740-454-1216
Practice Address - Fax:740-454-3830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0751566Medicaid
OH=========OtherFED ID
OH=========00OtherGROUP BWC
OH=========OtherFED ID
OHE85301Medicare UPIN