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General NPI Number Information
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NPI Number | 1285722587
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Entity Type | Organization
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Legal Business Name | EYE SURGEONS ASSOCIATES PC
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 777 TANGLEFOOT LANE
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City | BETTENDORF
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State | IA
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Zip | 52722-1650
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Country | US
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Telephone | 563-323-2020
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Fax | 563-328-5694
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Provider Business Mailing Address
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Address Line | 777 TANGLEFOOT LANE
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City | BETTENDORF
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State | IA
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Zip | 52722-1650
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Country | US
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Telephone | 563-323-2020
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Fax | 563-328-5694
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Authorized Official
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Title or Position | QUALITY IMPROVEMENT DIRECTOR
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Name | MRS. PATRICIA A FERCHEN
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Credential | R.N.
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Telephone | 563-323-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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