MEDICARE: DAYTON EYE ASSOCIATES

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1275657728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTON EYE ASSOCIATES

Provider Business Mailing Address
First Line	:	89 SYLVANIA DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-3281
Country	:	US
Telephone Number	:	937-320-2020
Fax Number	:	937-320-0504

Provider Business Practice Location Address
First Line	:	77 E WOODBURY DR
Second Line	:	SUITE 100
City	:	DAYTON
State	:	OH
Zip	:	45415-2855
Country	:	US
Telephone Number	:	937-276-2020
Fax Number	:	937-276-2590

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	JENNY WOOD
Credential	:
Telephone Number	:	937-320-2020

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	06/25/2009

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Directions to “DAYTON EYE ASSOCIATES ” Practice Location

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