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General NPI Number Information
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NPI Number | 1366402638
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Entity Type | Organization
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Legal Business Name | ANDERSEN EYE ASSOCIATES, PLC
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 5161 CARDINAL PARK DRIVE
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City | SAGINAW
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State | MI
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Zip | 48604-9435
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Country | US
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Telephone | 989-797-2400
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Fax | 989-249-1035
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Provider Business Mailing Address
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Address Line | PO BOX 5649
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City | SAGINAW
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State | MI
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Zip | 48603-0649
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Country | US
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Telephone | 989-797-2400
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Fax | 989-249-1035
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LAWRENCE C. HAZEN
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Credential | D.O.
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Telephone | 989-249-1030
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 1601000116
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License Number State | MI
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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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