Organization
MATTOON EYE CENTER S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD DWIGHT MILLER MD (PRESIDENT)
(217) 234-3937
Entity
Organization
Contact information
Practice address
220 RICHMOND AVE E, MATTOON, IL 61938-4652
(217) 234-3937
(217) 234-3930
Mailing address
220 RICHMOND AVE E, MATTOON, IL 61938-4652
(217) 234-3937
(217) 234-3930
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036060611
IL
332BC3200X
Customized Equipment (DME)
036060611
IL
Other
Enumeration date
10/22/2007
Last updated
03/26/2012
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