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EYECENTER PA NPI 1174632244


NPI Information

NPI: 1174632244
Provider Name: EYECENTER PA

Doing Business As: KETCHUM EYECENTER

Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
180 1ST AVE N
KETCHUM, ID
ZIP 83340
Phone: (208) 726-3363
Get Directions

EYECENTER PA is an optometrist in Ketchum, ID. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. EYECENTER PA NPI is 1174632244. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ketchum Eyecenter.

The provider's business location address is:

180 1ST AVE N
KETCHUM, ID
ZIP 83340-129
Phone: (208) 726-3363
Fax: (208) 726-0138

The provider's authorized official is Robert B Grill .
The authorized official title is Owner Optometrist and has the following contact phone number (208) 734-9800.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 1/8/2008.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10392220004MEDICARE NSC
2CP7637OTHERTRAVELERS RR MEDICARE GRP
31371254MEDICARE ID-TYPE UNSPECIFIED

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: 5/5/2024

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