MEDICARE: CLEVELAND EYE SPECIALISTS AND CONSULTANTS, 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	207W00000X	Ophthalmology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CD7175	OTHER	OH	RAILROAD MEDICARE
3	1193810001	OTHER	OH	DMERC MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1710970868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEVELAND EYE SPECIALISTS AND CONSULTANTS, INC.

Provider Business Mailing Address
First Line	:	1611 S GREEN RD
Second Line	:	SUITE 306B
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-4128
Country	:	US
Telephone Number	:	216-291-3550
Fax Number	:	216-291-4849

Provider Business Practice Location Address
First Line	:	1611 S GREEN RD
Second Line	:	SUITE 306B
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-4128
Country	:	US
Telephone Number	:	216-291-3550
Fax Number	:	216-291-4849

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID J MITCHELL
Credential	:	M.D.
Telephone Number	:	216-291-3550

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	08/17/2018

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1497744882 — KATHLEEN A LAMPING MD
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1611 S GREEN RD , SUITE 035
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1144211962 — DR. JAMES THOMAS LESLIE M.D.
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Practice Location Address:

1611 S GREEN RD
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44121-4128

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1356320162 — ELIZABETH LEAH HELLERSTEIN M.D.
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Directions to “CLEVELAND EYE SPECIALISTS AND CONSULTANTS, INC. ” Practice Location

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