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General NPI Number Information
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NPI Number | 1689657058
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Entity Type | Organization
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Legal Business Name | CENTER FOR ADVANCED EYE SURGERY, LTD
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1031 W WESTERN RESERVE RD
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City | POLAND
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State | OH
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Zip | 44514-3541
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Country | US
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Telephone | 330-965-0900
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Fax | 330-743-8368
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Provider Business Mailing Address
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Address Line | 1031 W WESTERN RESERVE RD
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City | POLAND
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State | OH
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Zip | 44514-3541
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Country | US
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Telephone | 330-965-0900
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Fax | 330-743-8368
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | KAYLA R WOLSIEFER
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Credential |
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Telephone | 330-884-6584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 0548AS
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License Number State | OH
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