1841322708 NPI number — EYE CONSULTANTS INCORPORATED

Table of content: (NPI 1841322708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841322708 NPI number — EYE CONSULTANTS INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EYE CONSULTANTS INCORPORATED
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841322708
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
64 DOCTORS PARK
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAPE GIRARDEAU
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63703-4928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-334-5265
Provider Business Mailing Address Fax Number:
573-334-3648

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
707 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRYVILLE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63775-1303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-334-5265
Provider Business Practice Location Address Fax Number:
573-334-3648
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RINGER
Authorized Official First Name:
CARL
Authorized Official Middle Name:
NELSON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
573-334-5265

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 180029379 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 911 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: P8985 . This is a "CHAMPUS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 131683 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1361772 . This is a "UNITED MINE WORKERS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 27626 . This is a "GROUP HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 27949 . This is a "GROUP HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 106713 . This is a "BLULE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 59946 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 332866 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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