Organization
WESTERN RESERVE OPHTHALMOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA FERRILL (OFFICE MANAGER)
(216) 514-1864
Entity
Organization
Contact information
Practice address
23250 CHAGRIN BLVD, SUITE 440, BEACHWOOD, OH 44122-5470
(216) 514-1864
(216) 514-1867
Mailing address
23250 CHAGRIN BLVD STE 440, BEACHWOOD, OH 44122-5445
(216) 514-1864
(216) 514-1867
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000167534
ANTHEM BC BS
OH
05
—
0889605
—
OH
01
—
CN0841
MEDICARE RAILROAD
OH
01
—
DA9250771
MEDICARE DMERK
OH
Enumeration date
05/25/2007
Last updated
05/16/2012
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