Mattoon Eye Center S C

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036060611 Issued in IL

Legal business name

MATTOON EYE CENTER S C

Practice address

220 Richmond Ave E
Mattoon, IL 61938-4652

Phone

(217) 234-3937

Fax

(217) 234-3930

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Dwight Miller, MD

Title

President

Phone

(217) 234-3937

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1922297472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RICHMOND AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384652",
            "telephone_number": "217-234-3937",
            "fax_number": "217-234-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RICHMOND AVE E",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384652",
            "telephone_number": "217-234-3937",
            "fax_number": "217-234-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTOON EYE CENTER S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DWIGHT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-234-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036060611",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "IL",
            "license": "036060611",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mattoon Chiropractic LLC
• Mattoon Comm Unit School Dist 2
• Mattoon Dental PC
• Mattoon Estates North, LLC
• Mattoon Estates South, LLC
• Mattoon Furniture
• Mattoon Healthcare & Rehabilitation Center
• Mattoon Manor, LLC (Mattoon Rehabilitation & Health Care Center)
• Mattoon Vision Associates (Mattoon Community Eyecare)
• Nicole Maus, CRNA

• Ophthalmology Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.