Organization
NORTHERN OHIO MEDICAL SPECIALISTS,LLC
Active
Other names
NOMS Eye
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA G FREDERICK (CEO)
(419) 626-6161
Entity
Organization
Contact information
Practice address
32730 WALKER RD STE J1, AVON LAKE, OH 44012-2235
(440) 961-2040
(440) 961-2041
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 626-6161
(419) 502-3537
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0323193
—
OH
Enumeration date
09/22/2017
Last updated
01/13/2021
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