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General NPI Number Information
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NPI Number | 1366470957
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Entity Type | Organization
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Legal Business Name | PRECISION EYE CARE, INC.
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 04/27/2009
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Provider Practice Location Address
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Address Line | 140 WESTMOUNT DR
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City | FARMINGTON
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State | MO
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Zip | 63640-2970
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Country | US
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Telephone | 573-756-2020
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Fax | 573-756-6997
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Provider Business Mailing Address
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Address Line | 140 WESTMOUNT DR
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City | FARMINGTON
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State | MO
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Zip | 63640-2970
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Country | US
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Telephone | 573-756-2020
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Fax | 573-756-6997
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | JOHN R FITZ
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Credential | MD
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Telephone | 573-756-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MO
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