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NPI Code Detail

MEDICARE: COLUMBUS EYE ASSOCIATES, P.C. INC

MEDICARE: COLUMBUS EYE ASSOCIATES, P.C. INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology PhysicianMD25517OR

General Provider Information

NPI Number : 1437452331
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLUMBUS EYE ASSOCIATES, P.C. INC
Provider Business Mailing Address
First Line : 7421 SW BRIDGEPORT RD
Second Line : STE 200
City : TIGARD
State : OR
Zip : 97224-7707
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7840 MONTGOMERY RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-4301
Country : US
Telephone Number : 513-354-5827
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF MANAGED CARE
Name : TERRI ROUSE
Credential :
Telephone Number : 513-354-5827
Provider Enumeration Date : 12/15/2010
Last Update Date : 12/15/2010

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