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General NPI Number Information
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NPI Number | 1841525821
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Entity Type | Organization
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Legal Business Name | ENVISION EYE CARE PLLC
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 4515 NESTLE ST
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City | CASS CITY
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State | MI
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Zip | 48726-1126
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Country | US
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Telephone | 989-872-4900
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Fax | 989-912-2225
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Provider Business Mailing Address
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Address Line | 5310 HAMPTON PL SUITE 2
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City | SAGINAW
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State | MI
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Zip | 48604-8202
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Country | US
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Telephone | 989-799-2020
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Fax | 989-799-8700
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Authorized Official
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Title or Position | OWNER
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Name | DAVID B KREBS
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Credential | M.D.
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Telephone | 989-799-2020
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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 | 4301075068
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License Number State | MI
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