Healthcare Provider Details

I. General information

NPI: 1518010842
Provider Name (Legal Business Name): ANDERSON HILLS EYE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 HOME ST
GEORGETOWN OH
45121-1478
US

IV. Provider business mailing address

7815 BEECHMONT AVE
CINCINNATI OH
45255-4207
US

V. Phone/Fax

Practice location:
  • Phone: 937-378-0031
  • Fax: 937-378-1337
Mailing address:
  • Phone: 513-388-4000
  • Fax: 513-388-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DAVID HOWARD
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 513-388-4000