Basic Information
| Provider Information | |||||||||
| NPI: | 1871888669 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTHEAST OHIO EYE SURGEONS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2013 STATE ROUTE 59 | ||||||||
| Address2: | |||||||||
| City: | KENT | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442404113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306780201 | ||||||||
| FaxNumber: | 3306784272 | ||||||||
| Practice Location | |||||||||
| Address1: | 4099 EMBASSY PARKWAY | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 44333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308351844 | ||||||||
| FaxNumber: | 3308368598 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2011 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | LOHMAN | ||||||||
| AuthorizedOfficialFirstName: | LAWRENCE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 3306780201 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | N | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.