Healthcare Provider Details

I. General information

NPI: 1780629337
Provider Name (Legal Business Name): WOOSTER OPHTHALMOLOGISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 FRIENDSVILLE RD
WOOSTER OH
44691-1241
US

IV. Provider business mailing address

3519 FRIENDSVILLE RD
WOOSTER OH
44691-1241
US

V. Phone/Fax

Practice location:
  • Phone: 330-345-7200
  • Fax: 330-345-8029
Mailing address:
  • Phone: 330-345-7200
  • Fax: 330-345-8029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY W PERKINS
Title or Position: PRESIDENT
Credential: MD
Phone: 330-345-7200