# JOHN J. ANTALIS, MD INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JOHN J. ANTALIS, MD
- **Other names:** John J. Antalis, MD INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780709592
- **Legal business name:** JOHN J. ANTALIS, MD
- **Authorized official:** JOHN J ANTALIS (OWNER)
- **Authorized official phone:** (740) 439-3020

## Contact information

- **Practice address:** 1502 DEERPATH DR, CAMBRIDGE, OH 43725-9240
- **Practice address phone:** (740) 439-3020
- **Practice address fax:** (740) 432-5487
- **Mailing address:** 1502 DEERPATH DR, CAMBRIDGE, OH 43725-9240
- **Mailing address phone:** (740) 439-3020
- **Mailing address fax:** (740) 432-5487

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 35060862 | OH | Yes |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 07/16/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0916003 | — | OH |
| 01 | — | 180036464 | RAILROAD MEDICARE | OH |
| 01 | — | DG0782 | RRB/ MEDICARE GROUP | OH |