Healthcare Provider Details

I. General information

NPI: 1427091164
Provider Name (Legal Business Name): OHIO EYE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 S TRIMBLE RD
MANSFIELD OH
44906-3416
US

IV. Provider business mailing address

466 S TRIMBLE RD
MANSFIELD OH
44906-3416
US

V. Phone/Fax

Practice location:
  • Phone: 419-756-8000
  • Fax: 419-756-7100
Mailing address:
  • Phone: 419-756-8000
  • Fax: 419-756-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberPC022168950 03
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN M SKARIE
Title or Position: ADMINISTRATOR
Credential: MD
Phone: 419-756-8000