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General NPI Number Information
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NPI Number | 1114181021
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Entity Type | Organization
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Legal Business Name | TUTTLE EYE ASSOCIATES INC
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 5043 TUTTLE CROSSING BLVD
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City | DUBLIN
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State | OH
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Zip | 43016-1511
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Country | US
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Telephone | 440-724-0396
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Fax |
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Provider Business Mailing Address
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Address Line | 2859 ACARIE DR
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City | COLUMBUS
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State | OH
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Zip | 43219-6198
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Country | US
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Telephone | 440-724-0396
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. GEORGE DEMETRIOS POULOS
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Credential | O.D.
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Telephone | 440-724-0396
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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 | 4581
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License Number State | OH
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