Provider Demographics
NPI:1316905680
Name:OHIO EYE SURGERY CENTER
Entity type:Organization
Organization Name:OHIO EYE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-774-4434
Mailing Address - Street 1:50 N PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1757
Mailing Address - Country:US
Mailing Address - Phone:844-974-4434
Mailing Address - Fax:740-774-4061
Practice Address - Street 1:155 E CIRCLE LN
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113-7566
Practice Address - Country:US
Practice Address - Phone:740-477-7200
Practice Address - Fax:740-477-8349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0174645Medicaid
OH3610611Medicare ID - Type Unspecified