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General NPI Number Information
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NPI Number | 1316043110
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Entity Type | Organization
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Legal Business Name | DRS. RAVIN, BIRNDORF & RAVIN, INC.
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3000 REGENCY CT STE 100
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City | TOLEDO
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State | OH
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Zip | 43623-3081
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Country | US
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Telephone | 419-882-2020
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Fax | 419-885-8440
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Provider Business Mailing Address
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Address Line | 850 W NORTH ST STE 104
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City | JACKSON
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State | MI
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Zip | 49202-3196
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Country | US
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Telephone | 877-852-8463
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Fax | 517-817-0144
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Authorized Official
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Title or Position | CEO
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Name | THOMAS T ROARK
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Credential |
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Telephone | 517-841-3007
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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