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NPI Code Detail

MEDICARE: EYE DOC INC.

MEDICARE: EYE DOC INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist453NV

General Provider Information

NPI Number : 1437484896
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE DOC INC.
Provider Business Mailing Address
First Line : 8512 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1818
Country : US
Telephone Number : 702-450-3937
Fax Number : 702-933-9094
Provider Business Practice Location Address
First Line : 8512 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-1818
Country : US
Telephone Number : 702-450-3937
Fax Number : 702-933-9094
Authorized Official
Title or Position : OWNER
Name : MISS KELLI ANNE MCLAUGHLIN
Credential : O.D.
Telephone Number : 702-450-3937
Provider Enumeration Date : 10/02/2009
Last Update Date : 10/02/2009

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Directions to “EYE DOC INC. ” Practice Location

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