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General NPI Number Information
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NPI Number | 1487664546
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Entity Type | Organization
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Legal Business Name | U P EYE SPECIALISTS PLC
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 1414 W FAIR AVE SUITE 347
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City | MARQUETTE
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State | MI
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Zip | 49855
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Country | US
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Telephone | 906-225-4512
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Fax | 906-225-4514
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Provider Business Mailing Address
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Address Line | 1414 W FAIR AVE SUITE 347
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City | MARQUETTE
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State | MI
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Zip | 49855
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Country | US
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Telephone | 906-225-4512
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Fax | 906-225-4514
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Authorized Official
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Title or Position | OWNER PARTNER
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Name | DR. MARK W ULRICKSON
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Credential | DO PC
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Telephone | 906-225-4512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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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