Provider Demographics
NPI:1952354136
Name:STAHL VISION INC
Entity type:Organization
Organization Name:STAHL VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-427-2020
Mailing Address - Street 1:4235 INDIAN RIPPLE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3247
Mailing Address - Country:US
Mailing Address - Phone:937-427-2020
Mailing Address - Fax:937-429-1166
Practice Address - Street 1:4235 INDIAN RIPPLE RD
Practice Address - Street 2:STE 100
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-3247
Practice Address - Country:US
Practice Address - Phone:937-427-2020
Practice Address - Fax:937-429-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2022-11-30
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
OH2150185Medicaid
OH9307621Medicare PIN
OH2150185Medicaid