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1295531481 NPI number — OHIO EYE OPTOMETRIC, LLC

NPI Number: 1295531481
Health Care Provider/Practitioner: OHIO EYE OPTOMETRIC, LLC

Information about “1295531481” NPI (OHIO EYE OPTOMETRIC, LLC) exists in 1295531481 in HTML format HTML  |  1295531481 in plain Text format TXT  |  1295531481 in PDF (Portable Document Format) PDF  |  1295531481 in an XML format XML  formats.

NPI Number : 1295531481 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295531481",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "OHIO EYE OPTOMETRIC, LLC",
    "ParentOrgTIN": null,
    "OrgName": "OHIO EYE OPTOMETRIC, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "466 S TRIMBLE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MANSFIELD",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44906-3416",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "419-756-8000",
    "MailingAddressFaxNumber": "419-756-2601",
    "FirstLinePracticeLocationAddress": "110 COSHOCTON AVE STE C",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOUNT VERNON",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43050-2628",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "419-756-8000",
    "PracticeLocationAddressFaxNumber": "419-756-2601",
    "EnumerationDate": "02/20/2025",
    "LastUpdateDate": "02/20/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ELLIS",
    "AuthorizedOfficialFirstName": "STACY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CREDENTIALING SPECIALIST",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "419-774-3402",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "332H00000X",
        "TaxonomyName": "Eyewear Supplier",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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