MEDICARE: EYE CARE ASSOCIATES, 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	152W00000X	Optometrist
2	207W00000X	Ophthalmology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CB4057	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447203088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CARE ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	10 DUTTON DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44502-1818
Country	:	US
Telephone Number	:	330-884-6584
Fax Number	:	330-743-8368

Provider Business Practice Location Address
First Line	:	10 DUTTON DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44502-1818
Country	:	US
Telephone Number	:	330-746-7691
Fax Number	:	330-743-8368

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	KAYLA R WOLSIEFER
Credential	:
Telephone Number	:	330-884-6584

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	01/06/2025

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Directions to “EYE CARE ASSOCIATES, INC ” Practice Location

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