Organization
MIDWEST EYE SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE C BARBERY (ADMINISTRATOR)
(859) 344-2062
Entity
Organization
Contact information
Practice address
4452 EASTGATE BLVD, SUITE 305, CINCINNATI, OH 45245-1584
(513) 752-5700
(513) 752-5716
Mailing address
2865 CHANCELLOR DR, SUITE 215, CRESTVIEW HILLS, KY 41017-3912
(859) 344-2079
(859) 581-7207
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
0087AS
OH
367500000X
Certified Registered Nurse Anesthetist
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163517
—
OH
01
—
490002965
RR MEDICARE
—
05
—
7100401680
—
KY
Enumeration date
07/20/2015
Last updated
02/16/2017
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