Healthcare Provider Details

I. General information

NPI: 1194825836
Provider Name (Legal Business Name): WASHINGTON EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8703 26 MILE RD
WASHINGTON MI
48094-2967
US

IV. Provider business mailing address

8703 26 MILE RD
WASHINGTON MI
48094-2967
US

V. Phone/Fax

Practice location:
  • Phone: 586-992-3700
  • Fax: 586-992-3706
Mailing address:
  • Phone: 586-992-3700
  • Fax: 586-992-3706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4901003653
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4901004085
License Number StateMI

VIII. Authorized Official

Name: DR. BARBARA HORN
Title or Position: OWNER
Credential: OD
Phone: 586-992-3700