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General NPI Number Information
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NPI Number | 1972742526
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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 | 02/05/2009
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Last Update Date | 05/15/2013
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Provider Practice Location Address
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Address Line | 901 LAKESHORE DR SUITE 102
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City | ISHPEMING
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State | MI
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Zip | 49849-1367
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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 | 49855-2675
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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 | DOUGLAS R SHEARER
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Credential | MDPC
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | MI
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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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