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General NPI Number Information
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NPI Number | 1538264981
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Entity Type | Organization
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Legal Business Name | EDINA EYE PHYSICIANS AND SURGEONS PA
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 560 S MAPLE ST SUITE110
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City | WACONIA
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State | MN
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Zip | 55387-1763
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Country | US
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Telephone | 952-442-4445
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Fax | 952-832-8148
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Provider Business Mailing Address
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Address Line | 7450 FRANCE AVE S SUITE 100
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City | EDINA
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State | MN
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Zip | 55435-4787
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Country | US
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Telephone | 952-832-8100
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Fax | 952-832-8148
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY J STEPHENS
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Credential |
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Telephone | 612-999-2020
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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 | 7314104
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 7314104
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License Number State | MN
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