Eye Surgeon Associates, Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35063310 Issued in OH

Legal business name

EYE SURGEON ASSOCIATES, INC.

Practice address

1490 Pinehurst Dr
Defiance, OH 43512-8670

Phone

(419) 782-6588

Fax

(419) 784-3622

NPI assigned

Apr 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Philip H. O'Donnell, M.D.NPI 1538126123

Title

Owner/President

Phone

(419) 782-6588

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Philip H. O'Donnell, M.D.

  • Ophthalmology Physician
  • Defiance, OH
  • NPI 1538126123
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386601193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 PINEHURST DR",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435128670",
            "telephone_number": "419-782-6588",
            "fax_number": "419-784-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 PINEHURST DR",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435128670",
            "telephone_number": "419-782-6588",
            "fax_number": "419-784-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SURGEON ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'DONNELL",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "419-782-6588",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35063310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0922381",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kermit R Erwin, MD
• Amanda Everaert
• Diana Evers
• Rosa Evers, RN
• Everside Health, LLC
• Fairchild Family Chiropractic, LLC
• Anthony Wayne Fairchild Jr., DC
• Kayla May Fairchild, DC
• Fauster Cameron Inc. (Defiance Clinic)
• Fauster Cameron Inc., Dba Defiance Clinic

• Ophthalmology Physician in Defiance, OH
• Providers in Defiance, OH by specialty
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.