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General NPI Number Information
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NPI Number | 1376680280
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Entity Type | Organization
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Legal Business Name | CLEVELAND EYE SPECIALISTS AND CONSULTANTS, INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 10/23/2007
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Provider Practice Location Address
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Address Line | 12000 MCCRACKEN RD SUITE 215
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City | GARFIELD HTS
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State | OH
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Zip | 44125-2964
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Country | US
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Telephone | 216-581-6111
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Fax | 216-291-4849
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Provider Business Mailing Address
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Address Line | 1611 S GREEN RD SUITE 306B
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City | SOUTH EUCLID
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State | OH
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Zip | 44121-4128
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Country | US
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Telephone | 216-291-3550
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Fax | 216-291-4849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID J MITCHELL
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Credential | MD
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Telephone | 216-291-3550
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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 |
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License Number State |
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