Organization
SOUTHERN OHIO EYE SURGICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN EDWARD DEMICK MD (OWNER)
(740) 773-6347
Entity
Organization
Contact information
Practice address
159 E 2ND ST, CHILLICOTHE, OH 45601-2526
(740) 773-6347
(740) 773-9093
Mailing address
159 E 2ND ST, CHILLICOTHE, OH 45601-2526
(740) 773-6347
(740) 773-9093
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4930
OH
207W00000X
Ophthalmology Physician
22313
WV
207W00000X
Ophthalmology Physician
Primary
35059420D
OH
207W00000X
Ophthalmology Physician
35078998E
OH
207W00000X
Ophthalmology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2383951
—
OH
05
—
2383988
—
OH
05
—
2544367
—
OH
01
—
5257400001
MEDICARE DME MAC
OH
Enumeration date
06/24/2006
Last updated
02/11/2008
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