# EYE LASER AND SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1578881009
- **Authorized official:** BRIAN R STAHL M.D. (MANAGING PARTNER/PRESIDENT)
- **Authorized official phone:** (937) 427-2020

## Contact information

- **Practice address:** 4235 INDIAN RIPPLE RD, STE 110, BEAVERCREEK, OH 45440-3265
- **Practice address phone:** (937) 427-7800
- **Practice address fax:** (937) 427-7803
- **Mailing address:** 4235 INDIAN RIPPLE RD, STE 110, BEAVERCREEK, OH 45440-3265
- **Mailing address phone:** (937) 427-7800
- **Mailing address fax:** (937) 427-7803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0991AS | OH | Yes |
| 261QS0132X | Ophthalmologic Surgery Clinic/Center | 0991AS | OH | — |

## Other

- **Enumeration date:** 05/07/2010
- **Last updated:** 01/10/2013