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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