Organization
SOUTHERN OHIO EYE SURGICAL ASSOC., LLC
Active
Organization
SOUTHERN OHIO EYE SURGICAL ASSOC., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN DEMICK (OWNER)
(740) 773-6347
Entity
Organization
Contact information
Practice address
1456 JACKSON PIKE, SUITE 2, GALLIPOLIS, OH 45631-2602
(740) 446-0112
Mailing address
159 E 2ND ST, CHILLICOTHE, OH 45601-2526
(740) 773-6347
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
27012133
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5257400001
MEDICARE NGS
OH
Enumeration date
04/07/2008
Last updated
09/03/2008
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