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General NPI Number Information
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NPI Number | 1154526408
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Entity Type | Organization
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Legal Business Name | THE SURGICAL EYE CARE CENTER
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 12/03/2007
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Provider Practice Location Address
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Address Line | 95 ARCH ST STE 120
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City | AKRON
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State | OH
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Zip | 44304-1479
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Country | US
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Telephone | 330-535-2521
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Fax | 330-535-6845
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Provider Business Mailing Address
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Address Line | 95 ARCH ST STE 120
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City | AKRON
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State | OH
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Zip | 44304-1479
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Country | US
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Telephone | 330-535-2521
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Fax | 330-535-6845
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS A REPKO
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Credential | MD
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Telephone | 330-535-2521
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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 | 35047918
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License Number State | OH
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