MEDICARE: EYE CARE SPECIALISTS, P.C.

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	207W00000X	Ophthalmology Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1497808315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYE CARE SPECIALISTS, P.C.

Provider Business Mailing Address
First Line	:	703 RUTTER AVE
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-4801
Country	:	US
Telephone Number	:	570-288-7405
Fax Number	:	570-288-7406

Provider Business Practice Location Address
First Line	:	40 DALLAS VILLAGE SHOPPING CTR
Second Line	:
City	:	DALLAS
State	:	PA
Zip	:	18612-1231
Country	:	US
Telephone Number	:	570-674-9001
Fax Number	:	570-674-9088

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	ERIK F KRUGER
Credential	:	M.D.
Telephone Number	:	570-288-7405

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	03/10/2015

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