MEDICARE: STAHL VISION 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

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	:	1952354136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAHL VISION INC

Provider Business Mailing Address
First Line	:	4235 INDIAN RIPPLE RD
Second Line	:	STE 100
City	:	BEAVERCREEK
State	:	OH
Zip	:	45440-3247
Country	:	US
Telephone Number	:	937-427-2020
Fax Number	:	937-429-1166

Provider Business Practice Location Address
First Line	:	4235 INDIAN RIPPLE RD
Second Line	:	STE 100
City	:	BEAVERCREEK
State	:	OH
Zip	:	45440-3247
Country	:	US
Telephone Number	:	937-427-2020
Fax Number	:	937-429-1166

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN RAY STAHL
Credential	:	M.D.
Telephone Number	:	937-427-2020

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	11/30/2022

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Directions to “STAHL VISION INC ” Practice Location

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