Healthcare Provider Details

I. General information

NPI: 1962597096
Provider Name (Legal Business Name): REGIONAL EYE SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 MONTREAL ST SE
HUTCHINSON MN
55350-0699
US

IV. Provider business mailing address

1455 MONTREAL ST SE P O BOX 699
HUTCHINSON MN
55350-0699
US

V. Phone/Fax

Practice location:
  • Phone: 320-587-6308
  • Fax: 320-587-2974
Mailing address:
  • Phone: 320-587-6308
  • Fax: 320-587-2974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAWN WHIPPLE
Title or Position: NATIONAL MANAGER OF CREDENTIALING
Credential:
Phone: 952-567-6125