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PLASTIC AND RECONSTRUCTIVE EYE SURGERY PC NPI 1417998337


NPI Information

NPI: 1417998337
Provider Name: PLASTIC AND RECONSTRUCTIVE EYE SURGERY PC
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
2757 LEONARD ST NE
GRAND RAPIDS, MI
ZIP 49525
Phone: (616) 942-6687
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PLASTIC AND RECONSTRUCTIVE EYE SURGERY PC is an ophthalmology in Grand Rapids, MI. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. PLASTIC AND RECONSTRUCTIVE EYE SURGERY PC NPI is 1417998337. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2757 LEONARD ST NE
GRAND RAPIDS, MI
ZIP 49525-807
Phone: (616) 942-6687
Fax: (616) 942-9797

The provider's authorized official is Melissa Lynn Meldrum .
The authorized official title is Owner President and has the following contact phone number (616) 942-6687.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 6/2/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DC7010OTHERMICHIGANRAILROAD MEDICARE
20P07970MEDICARE PINMICHIGAN
3180D117010OTHERMICHIGANBCBSM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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