MEDICARE: THE EYE DOCTORS OFFICE, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2244	MN

General Provider Information

NPI Number	:	1003260290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE EYE DOCTORS OFFICE, PA

Provider Business Mailing Address
First Line	:	4999 FRANCE AVE S
Second Line	:	SUITE 140
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55410-1703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4999 FRANCE AVE S
Second Line	:	SUITE 140
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55410-1703
Country	:	US
Telephone Number	:	612-440-2020
Fax Number	:	612-440-0202

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY P HAUPERT
Credential	:	OD
Telephone Number	:	612-940-1717

Provider Enumeration Date	:	04/14/2016
Last Update Date	:	03/26/2023

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Directions to “THE EYE DOCTORS OFFICE, PA ” Practice Location

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