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General NPI Number Information
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NPI Number | 1275683005
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Entity Type | Organization
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Legal Business Name | EYE SERVICES LLC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 04/28/2009
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Provider Practice Location Address
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Address Line | 671 W MAIN ST
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City | WILMINGTON
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State | OH
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Zip | 45177-2124
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Country | US
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Telephone | 937-383-3277
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Fax | 937-283-9146
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Provider Business Mailing Address
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Address Line | 630 W MAIN ST MAIL 18
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City | WILMINGTON
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State | OH
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Zip | 45177-2170
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Country | US
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Telephone | 937-383-3277
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Fax | 937-283-9146
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHIA-HUNG JOSEPH CHEN
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Credential | M.D.
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Telephone | 937-383-3277
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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 | OH35075663C
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License Number State | OH
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