MEDICARE: TOTAL VISION CENTERS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152WC0802X	Corneal and Contact Management Optometrist	5397	OH
2	152WC0802X	Corneal and Contact Management Optometrist	5508	OH
3	152WC0802X	Corneal and Contact Management Optometrist	2703	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1205815065	OTHER	OH	NPI# DR. DUBRO
2	1710966585	OTHER	OH	NPI# DR. KUHN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083835102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL VISION CENTERS, INC

Provider Business Mailing Address
First Line	:	102 E LAKE AVE
Second Line	:
City	:	NEW CARLISLE
State	:	OH
Zip	:	45344-1417
Country	:	US
Telephone Number	:	937-845-0751
Fax Number	:	937-845-2931

Provider Business Practice Location Address
First Line	:	102 E LAKE AVE
Second Line	:
City	:	NEW CARLISLE
State	:	OH
Zip	:	45344-1417
Country	:	US
Telephone Number	:	937-845-0751
Fax Number	:	937-845-2931

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALLEN G DUBRO
Credential	:	OD
Telephone Number	:	937-845-0751

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	06/27/2008

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Directions to “TOTAL VISION CENTERS, INC ” Practice Location

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