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General NPI Number Information
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NPI Number | 1134543457
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Entity Type | Organization
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Legal Business Name | MED SURG EYE CARE INC
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Dates
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Enumeration Date | 02/06/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 22 MALLARD CT
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City | BECKLEY
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State | WV
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Zip | 25801-3615
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Country | US
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Telephone | 304-252-4216
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Fax | 304-253-6809
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Provider Business Mailing Address
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Address Line | PO BOX 172
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City | STANAFORD
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State | WV
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Zip | 25927-0172
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Country | US
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Telephone | 304-252-4216
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Fax | 304-253-6809
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAOUFIK A SADAT
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Credential | M.D.
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Telephone | 304-252-4216
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 20564
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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