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NPI Code Detail

MEDICARE: EDINA EYE PHYSICIANS AND SURGEONS PA

MEDICARE: EDINA EYE PHYSICIANS AND SURGEONS 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
1152W00000XOptometrist7314104MN
2207W00000XOphthalmology Physician7314104MN

General Provider Information

NPI Number : 1518058536
Entity Type Code : Organization
Provider Name (Legal Business Name) : EDINA EYE PHYSICIANS AND SURGEONS PA
Provider Business Mailing Address
First Line : 7450 FRANCE AVE S STE 100
Second Line :
City : EDINA
State : MN
Zip : 55435-4799
Country : US
Telephone Number : 612-999-2020
Fax Number : 952-832-8148
Provider Business Practice Location Address
First Line : 290 MAIN ST NW
Second Line :
City : ELK RIVER
State : MN
Zip : 55330-1270
Country : US
Telephone Number : 763-241-5878
Fax Number : 763-241-5877
Authorized Official
Title or Position : OWNER
Name : JEFFREY J STEPHENS
Credential :
Telephone Number : 612-999-2020
Provider Enumeration Date : 09/27/2006
Last Update Date : 01/28/2026

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Directions to “EDINA EYE PHYSICIANS AND SURGEONS PA ” Practice Location

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