Healthcare Provider Details

I. General information

NPI: 1396726667
Provider Name (Legal Business Name): THE EYE CENTER GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 STATE ROUTE 571
GREENVILLE OH
45331-9695
US

IV. Provider business mailing address

PO BOX 457
RICHMOND IN
47375-0457
US

V. Phone/Fax

Practice location:
  • Phone: 937-548-8229
  • Fax: 937-548-1911
Mailing address:
  • Phone: 765-966-1945
  • Fax: 765-966-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEFFREY S RAPKIN
Title or Position: PART OWNER
Credential: MD
Phone: 765-286-8888