Organization
DAYTON EYE SURGERY CENTER L L C
Active
Other names
Dayton Eye Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA WEISENBURGH (DON/ADMINISTRATOR)
(937) 431-9531
Entity
Organization
Contact information
Practice address
81 SYLVANIA DR, DAYTON, OH 45440-3237
(937) 431-9531
(937) 431-9532
Mailing address
81 SYLVANIA DR, DAYTON, OH 45440-3237
(937) 431-9531
(937) 431-9532
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0553AS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2138449
—
OH
01
—
490004334
MEDICARE RAILROAD
OH
01
—
64394
ANTHEM BLUE CROSS BLUE SHIELD
OH
01
—
6800130
UNITED HEALTH CARE
OH
Enumeration date
01/26/2007
Last updated
10/30/2024
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