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NPI Code Detail

MEDICARE: PINCONNING FAMILY EYE CARE PC

MEDICARE: PINCONNING FAMILY EYE CARE PC
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
1152W00000XOptometristRL003052MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073631040
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINCONNING FAMILY EYE CARE PC
Provider Business Mailing Address
First Line : 1948 N HURON RD
Second Line : P.O. BOX 325
City : PINCONNING
State : MI
Zip : 48650-7909
Country : US
Telephone Number : 989-879-3937
Fax Number : 989-879-3981
Provider Business Practice Location Address
First Line : 1948 N HURON RD
Second Line :
City : PINCONNING
State : MI
Zip : 48650-7909
Country : US
Telephone Number : 989-879-3937
Fax Number : 989-879-3981
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. RAYMOND ALLEN LALONDE
Credential : OD
Telephone Number : 989-879-3937
Provider Enumeration Date : 03/27/2007
Last Update Date : 09/03/2015

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Directions to “PINCONNING FAMILY EYE CARE PC ” Practice Location

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