Healthcare Provider Details

I. General information

NPI: 1588709950
Provider Name (Legal Business Name): OAKLEY SQUARE EYE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3039 MADISON RD
CINCINNATI OH
45209-1709
US

IV. Provider business mailing address

3039 MADISON RD
CINCINNATI OH
45209-1709
US

V. Phone/Fax

Practice location:
  • Phone: 513-651-4005
  • Fax: 513-651-4006
Mailing address:
  • Phone: 513-651-4005
  • Fax: 513-651-4006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3701T198
License Number StateOH

VIII. Authorized Official

Name: DR. PHILLIP E APFEL
Title or Position: OWNER
Credential: OD
Phone: 513-651-4005