Healthcare Provider Details

I. General information

NPI: 1144261108
Provider Name (Legal Business Name): OPHTHALMOLOGY ASSOCIATES OF NORTHWESTERN OHIO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 BRIARFIELD BLVD
MAUMEE OH
43537-9383
US

IV. Provider business mailing address

3509 BRIARFIELD BLVD.
MAUMEE OH
43537
US

V. Phone/Fax

Practice location:
  • Phone: 419-865-3866
  • Fax: 419-865-3451
Mailing address:
  • Phone: 419-865-3866
  • Fax: 419-865-3451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON E DUCHIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 419-865-3866