DRS. Milburn - Medina, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5133 Issued in OH

Legal business name

DRS. MILBURN - MEDINA, INC.

Practice address

409 North Court St
Medina, OH 44256

Phone

(330) 725-4680

Fax

(330) 725-2010

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Michael Milburn, O.D.

Title

President

Phone

(330) 725-4680

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1467577502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 NORTH COURT ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "44256",
            "telephone_number": "330-725-4680",
            "fax_number": "330-725-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 NORTH COURT ST",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "44256",
            "telephone_number": "330-725-4680",
            "fax_number": "330-725-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. MILBURN - MEDINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "MILBURN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-725-4680",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2980449",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Medina, OH
• Providers in Medina, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.