Organization
ADVANCED EYECARE & SPORTS VISION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALLAN MILLER OD (OWNER)
(614) 873-1003
Entity
Organization
Contact information
Practice address
302 WEST MAIN ST., STE 100, PLAIN CITY, OH 43064
(614) 873-1003
Mailing address
302 WEST MAIN ST., STE 100, PLAIN CITY, OH 43064
(614) 873-1003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4217/T949
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224728
ANTHEM
OH
05
—
0924450
—
OH
01
—
2200301
UNITED HEALTHCARE
OH
01
—
278681842004
MEDICAL MUTUAL
OH
01
—
5452035
AETNA
OH
01
—
DC0168
RAILROAD MEDICARE
—
Enumeration date
06/07/2006
Last updated
06/08/2009
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