MEDICARE: MORRISON EYE CARE OPTOMETRISTS, P.A.

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2129568	OTHER	MN	MEDICA CHOICE
2	483361046247	OTHER	MN	PREFERRED ONE
3	61720LA	OTHER	MN	BLUE CROSS BLUE SHIELD
4	4C962LA	OTHER	MN	BLUE PLUS
5	2202433	OTHER	MN	MEDICA CHOICE
6	2229855	OTHER	MN	MEDICA
7	483361046248	OTHER	MN	PREFERRED ONE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	2202433	OTHER	MN	MEDICA
10	V501629396	OTHER	MN	HEALTH PARTNERS

General Provider Information

NPI Number	:	1164517348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORRISON EYE CARE OPTOMETRISTS, P.A.

Provider Business Mailing Address
First Line	:	PO BOX 266
Second Line	:
City	:	DETROIT LAKES
State	:	MN
Zip	:	56502-0266
Country	:	US
Telephone Number	:	218-847-2020
Fax Number	:	218-847-6165

Provider Business Practice Location Address
First Line	:	1244 WASHINGTON AVE
Second Line	:
City	:	DETROIT LAKES
State	:	MN
Zip	:	56501-3906
Country	:	US
Telephone Number	:	218-847-2020
Fax Number	:	218-847-6165

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL ANTHONY MORRISON
Credential	:	OD
Telephone Number	:	218-847-2020

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/14/2025

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