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General NPI Number Information
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NPI Number | 1164432431
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Entity Type | Organization
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Legal Business Name | ASSOCIATED EYE PHYSICIANS AND SURGEONS, INC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1520 S MAIN ST
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City | DAYTON
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State | OH
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Zip | 45409-2698
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Country | US
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Telephone | 937-223-1279
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Fax | 937-223-9979
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Provider Business Mailing Address
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Address Line | 4148 RIDGEWAY RD
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City | KETTERING
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State | OH
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Zip | 45429-1640
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Country | US
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Telephone | 937-643-4049
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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. JOHN ANDREW FLEISHMAN
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Credential | M.D.
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Telephone | 937-223-1279
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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 | 35059036
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License Number State | OH
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