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General NPI Number Information
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NPI Number | 1710705371
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Entity Type | Organization
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Legal Business Name | GROVE CITY EYE SURGERY CENTER
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 3154 PARK ST
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City | GROVE CITY
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State | OH
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Zip | 43123-3222
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Country | US
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Telephone | 614-801-9111
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Fax | 614-801-1643
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Provider Business Mailing Address
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Address Line | 50 N PLAZA BLVD
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-1757
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Country | US
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Telephone | 740-774-4434
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LINDSEY WIESMAN
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Credential |
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Telephone | 740-774-4434
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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