Eli Dragisich OD Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

599OD Issued in WV

Legal business name

ELI DRAGISICH OD INC

Practice address

705 Colliers Way
Weirton, WV 26062-5016

Phone

(304) 723-1280

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eli Dragisich, O.D.

Title

President

Phone

(304) 723-1280

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1407936925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625016",
            "telephone_number": "304-723-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 COLLIERS WAY",
            "city": "WEIRTON",
            "state": "WV",
            "postal_code": "260625016",
            "telephone_number": "304-723-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELI DRAGISICH OD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "DRAGISICH",
        "authorized_official_first_name": "ELI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-723-1280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WV",
            "license": "599OD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150189000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Weirton, WV
• Providers in Weirton, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.