Healthcare Provider Details

I. General information

NPI: 1629057716
Provider Name (Legal Business Name): NORTHERN OHIO EYE CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 10/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 COOPER FOSTER PARK RD W
LORAIN OH
44053-3680
US

IV. Provider business mailing address

1710 COOPER FOSTER PARK RD W
LORAIN OH
44053-3680
US

V. Phone/Fax

Practice location:
  • Phone: 440-960-2020
  • Fax: 440-282-3300
Mailing address:
  • Phone: 440-960-2020
  • Fax: 440-282-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WILLIAM F WILEY
Title or Position: PRESIDENT
Credential: MD
Phone: 440-526-1974