# RAYMOND A BANNAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114088960
- **Authorized official:** RAYMOND ANTHONY BANNAN (OWNER)
- **Authorized official phone:** (740) 676-1121

## Contact information

- **Practice address:** 3372 BELMONT ST, BELLAIRE, OH 43906-1523
- **Practice address phone:** (740) 676-1121
- **Mailing address:** 3372 BELMONT ST, BELLAIRE, OH 43906-1523
- **Mailing address phone:** (740) 676-1121

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 35 054143 | OH | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 02/15/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0819930 | — | OH |
| 01 | — | 180012369 | RAILROAD MEDICARE | OH |
| 01 | — | DG5587 | RAILROAD MEDICARE GROUP | OH |