Organization
MIDWEST RETINA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TONI L TURK (PRACTICE ADMINISTRATOR)
(614) 233-9500
Entity
Organization
Contact information
Practice address
500 E MAIN ST STE 300, COLUMBUS, OH 43215-5369
(614) 233-9500
(614) 233-9501
Mailing address
500 E MAIN ST STE 300, COLUMBUS, OH 43215-5369
(614) 233-9500
(614) 233-9501
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OH35067637
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0164405
—
OH
01
—
274805710011
MEDICAL MUTUAL
OH
01
—
5730181
AETNA
OH
Enumeration date
12/26/2007
Last updated
12/26/2007
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