Provider Demographics
NPI:1427129352
Name:MID OHIO OPHTHALMIC CONSULTANTS, LTD
Entity type:Organization
Organization Name:MID OHIO OPHTHALMIC CONSULTANTS, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-488-8000
Mailing Address - Street 1:4830 KNIGHTSBRIDGE BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-2300
Mailing Address - Country:US
Mailing Address - Phone:614-488-0000
Mailing Address - Fax:614-488-8610
Practice Address - Street 1:4830 KNIGHTSBRIDGE BLVD STE G
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-2300
Practice Address - Country:US
Practice Address - Phone:614-488-0000
Practice Address - Fax:614-488-8610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2036200Medicaid
OH0654160001Medicare NSC
OHMI9292141Medicare PIN