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General NPI Number Information
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NPI Number | 1093316671
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Entity Type | Organization
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Legal Business Name | NORTHEAST OHIO EYE SURGEONS, INC.
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 4463 WEYMOUTH RD
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City | MEDINA
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State | OH
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Zip | 44256-9249
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Country | US
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Telephone | 330-678-0201
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Fax | 330-678-4272
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Provider Business Mailing Address
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Address Line | 2013 STATE ROUTE 59
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City | KENT
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State | OH
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Zip | 44240-4113
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Country | US
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Telephone | 330-678-0201
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Fax | 330-678-4272
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | LAWRENCE E LOHMAN
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Credential | MD
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Telephone | 330-678-0201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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