Practice Types & Subspecialty

Customer ID#

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Practice Name *

National Provider Identifier (NPI) - For U.S. Ophthalmologists only *

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-- Select a practice type -- Academic Institution Administration Government/Military Hospital/Healthcare System Medical Missionary/Humanitarian Multispecialty Group Ophthalmology Group Practice Other Research Solo Practice Primary *

-- Select a practice type -- Academic Institution Administration Government/Military Hospital/Healthcare System Medical Missionary/Humanitarian Multispecialty Group Ophthalmology Group Practice Other Research Solo Practice Secondary *

Enter your practice and subspecialty information

-- Select a subspecialty type -- Administration/Organization Leadership Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma International Ophthalmology Medical Education Neuro-Ophthalmology Ocular Oncology Oculofacial Plastics/Reconstructive Ophthalmic Genetics Ophthalmic Pathology Other Pediatric Ophthalmology & Strabismus Refractive Surgery Retina - medical only Retina/Vitreous - medical & surgery Uveitis/Immunology Vision Rehab Primary *

-- Select a subspecialty type -- Administration/Organization Leadership Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma International Ophthalmology Medical Education Neuro-Ophthalmology Ocular Oncology Oculofacial Plastics/Reconstructive Ophthalmic Genetics Ophthalmic Pathology Other Pediatric Ophthalmology & Strabismus Refractive Surgery Retina - medical only Retina/Vitreous - medical & surgery Uveitis/Immunology Vision Rehab Secondary *

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