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General NPI Number Information
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NPI Number | 1104083336
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Entity Type | Organization
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Legal Business Name | OPHTHALMIC PHYSICIANS INC
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 517 W PROSPECT RD
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City | ASHTABULA
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State | OH
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Zip | 44004-5864
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Country | US
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Telephone | 440-255-1115
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Fax |
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Provider Business Mailing Address
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Address Line | 9485 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-4597
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Country | US
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Telephone | 440-255-1115
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY CLELL RIFFLE
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Credential | MD
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Telephone | 440-255-1115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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