Healthcare Provider Details

I. General information

NPI: 1245579994
Provider Name (Legal Business Name): THE EYE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 DIVISION AVE STE E
EUGENE OR
97404
US

IV. Provider business mailing address

1550 OAK ST STE 3
EUGENE OR
97401-7701
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-2020
  • Fax: 541-683-2020
Mailing address:
  • Phone: 541-683-2020
  • Fax: 541-683-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1770664484
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerMEDICARE

VIII. Authorized Official

Name: JOHN H HAINES
Title or Position: OWNER
Credential: M.D.
Phone: 541-683-2020