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General NPI Number Information
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NPI Number | 1285767509
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Entity Type | Organization
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Legal Business Name | PAUL R GAYEFF OD PC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 2500 7TH AVE S SUITE 217
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City | ESCANABA
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State | MI
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Zip | 49829-1176
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Country | US
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Telephone | 906-789-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 7TH AVE S SUITE 217
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City | ESCANABA
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State | MI
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Zip | 49829-1176
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Country | US
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Telephone | 906-789-1400
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | PAUL R GAYEFF
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Credential | O.D.
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Telephone | 906-786-2664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002306
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License Number State | MI
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