MEDICARE: SOUTHERN OHIO EYE SURGICAL ASSOC., LLC

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	27012133	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5257400001	OTHER	OH	MEDICARE NGS

General Provider Information

NPI Number	:	1285807685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN OHIO EYE SURGICAL ASSOC., LLC

Provider Business Mailing Address
First Line	:	159 E 2ND ST
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-2526
Country	:	US
Telephone Number	:	740-773-6347
Fax Number	:

Provider Business Practice Location Address
First Line	:	1456 JACKSON PIKE
Second Line	:	SUITE 2
City	:	GALLIPOLIS
State	:	OH
Zip	:	45631-2602
Country	:	US
Telephone Number	:	740-446-0112
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN DEMICK
Credential	:
Telephone Number	:	740-773-6347

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	09/03/2008

Similar Medicare Providers

1972506038 — FAMILY HOME HEALTH PLUS, INC.
Practice Location Address:

1480 JACKSON PIKE
GALLIPOLIS, OH
45631-2602

Practice Phone: 740-441-1393
Practice Fax: 740-441-1398

1013132133 — MS. BETTE CROMER ALTHOF M.A.
Practice Location Address:

1456 JACKSON PIKE
GALLIPOLIS, OH
45631-2602

Practice Phone: 740-446-8289
Practice Fax: 740-446-2926

1902466709 — ON THE GO TRANSPORTATION SERVICES
Practice Location Address:

1456 JACKSON PIKE
GALLIPOLIS, OH
45631-2602

Practice Phone: 740-645-2268
Practice Fax: 740-446-7985

1992558845 — CARE ASSIST, LLC
Practice Location Address:

1480 JACKSON PIKE
GALLIPOLIS, OH
45631-2602

Practice Phone: 740-209-2963
Practice Fax:

1871455600 — DESIREE DAWN RUIZ MENDOZA
Practice Location Address:

543 PAXTON RD
GALLIPOLIS, OH
45631-8717

Practice Phone: 828-200-3710
Practice Fax:

1679009831 — DR. JORDON KENNETH MARCH M.D.
Practice Location Address:

100 JACKSON PIKE
GALLIPOLIS, OH
45631-1560

Practice Phone: 740-441-1949
Practice Fax:

Directions to “SOUTHERN OHIO EYE SURGICAL ASSOC., LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.