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General NPI Number Information
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NPI Number | 1194169227
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Entity Type | Organization
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Legal Business Name | OPHTHALMOLOGY INC
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 55 VILLAGE SQUARE DR BUILDING 24
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City | SOUTH KINGSTOWN
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State | RI
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Zip | 02879-8274
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Country | US
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Telephone | 401-272-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 150 E MANNING ST
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City | PROVIDENCE
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State | RI
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Zip | 02906-5109
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Country | US
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Telephone | 401-272-2020
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Fax | 401-421-5979
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT BAHR
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Credential | MD
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Telephone | 401-272-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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