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Organization
PERRYSBURG EYE CENTER, INC.
Active
Organization
PERRYSBURG EYE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN E CLARK M.D. (PRESIDENT/MEDICAL DIRECTOR)
(419) 874-3125
Entity
Organization
Contact information
Practice address
28370 KENSINGTON LN, SUITE A, PERRYSBURG, OH 43551-4163
(419) 874-3125
(419) 874-8606
Mailing address
28370 KENSINGTON LN, SUITE A, PERRYSBURG, OH 43551-4163
(419) 874-3125
(419) 874-8606
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2415265
—
OH
Enumeration date
07/07/2006
Last updated
09/10/2014
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