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General NPI Number Information
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NPI Number | 1679765994
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Entity Type | Organization
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Legal Business Name | OAKWOOD EYE CLINIC
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 2525 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45419-1505
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Country | US
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Telephone | 937-298-0550
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 FAR HILLS AVE
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City | DAYTON
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State | OH
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Zip | 45419-1505
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Country | US
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Telephone | 937-298-0550
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Fax |
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Authorized Official
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Title or Position | PHYSCIAN OWNER
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Name | DR. PARK ALAN STUDEBAKER
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Credential | O.D.
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Telephone | 937-298-0550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 3639 T
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License Number State | OH
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