MEDICARE: OAKLEY SQUARE EYE 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	3701T198	OH

General Provider Information

NPI Number	:	1588709950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKLEY SQUARE EYE ASSOCIATES INC

Provider Business Mailing Address
First Line	:	3039 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1709
Country	:	US
Telephone Number	:	513-651-4005
Fax Number	:	513-651-4006

Provider Business Practice Location Address
First Line	:	3039 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1709
Country	:	US
Telephone Number	:	513-651-4005
Fax Number	:	513-651-4006

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PHILLIP E APFEL
Credential	:	OD
Telephone Number	:	513-651-4005

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	06/17/2008

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