Provider Demographics
NPI:1730159336
Name:EYE SURGERY CENTER OF OHIO INC
Entity type:Organization
Organization Name:EYE SURGERY CENTER OF OHIO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-228-4500
Mailing Address - Street 1:262 NEIL AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-2362
Mailing Address - Country:US
Mailing Address - Phone:614-228-4500
Mailing Address - Fax:614-384-2966
Practice Address - Street 1:262 NEIL AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-2362
Practice Address - Country:US
Practice Address - Phone:614-228-4500
Practice Address - Fax:614-384-2979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0643076Medicaid
OH9920052Medicare PIN
OH0643076Medicaid