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General NPI Number Information
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NPI Number | 1619011251
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Entity Type | Individual
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Provider Name | EUGENE B PERSON O. D.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 35000 WARREN RD
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City | WESTLAND
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State | MI
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Zip | 48185-6223
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Country | US
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Telephone | 734-458-5588
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Fax |
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Provider Business Mailing Address
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Address Line | 2044 HOLLYWOOD AVE
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City | GROSSE POINTE WOODS
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State | MI
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Zip | 48236-1377
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Country | US
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Telephone | 313-886-9540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901003149
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License Number State | MI
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