Organization
SOUTHERN VISION CENTER, INC.
Active
Parent organization
SOUTHERN VISION CENTER, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN VISION CENTER, INC.
Authorized official
MR. MICHAEL P GILILAND O.D. (OPTOMETRIST)
(614) 491-3435
Entity
Organization
Contact information
Practice address
105 GREAT SOUTHERN BLVD, COLUMBUS, OH 43207-4001
(614) 491-3435
(614) 491-1699
Mailing address
105 GREAT SOUTHERN BLVD, COLUMBUS, OH 43207-4001
(614) 491-3435
(614) 491-1699
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3605
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000120727
ANTHEM
OH
01
—
1184130001
DMERC
OH
01
—
2200190
UNITED HEALTHCARE
OH
01
—
281566897004
MEDICAL MUTUAL
OH
Enumeration date
08/30/2006
Last updated
12/07/2007
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