Organization
OHIO RETINA ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA VAUGHN (PRACTICE ADMINISTRATOR)
(330) 966-9800
Entity
Organization
Contact information
Practice address
340 OXFORD ST STE 210, DOVER, OH 44622-1967
(330) 602-8351
(330) 602-7500
Mailing address
4690 MUNSON ST NW, CANTON, OH 44718-3636
(330) 966-9800
(330) 966-9803
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0149904
—
OH
01
—
DE4090
RAILROAD MEDICARE
OH
Enumeration date
07/27/2006
Last updated
11/01/2007
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