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OCULOPLASTIC ASSOCIATES OF WEST MICHIGAN PLC NPI 1174974356


NPI Information

NPI: 1174974356
Provider Name: OCULOPLASTIC ASSOCIATES OF WEST MICHIGAN, PLC
Classification: Ophthalmology - 207WX0200X
Entity Type: Organization

Specialization: Ophthalmic Plastic and Reconstructive Surgery

Address:
4070 LAKE DR SE
SUITE 205
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 888-2948
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OCULOPLASTIC ASSOCIATES OF WEST MICHIGAN, PLC is an ophthalmic plastic and reconstructive surgery ophthalmology in Grand Rapids, MI. The provider is a physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. OCULOPLASTIC ASSOCIATES OF WEST MICHIGAN, PLC NPI is 1174974356. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4070 LAKE DR SE
SUITE 205
GRAND RAPIDS, MI
ZIP 49546-294
Phone: (616) 888-2948
Fax: (616) 888-2949

The provider's authorized official is Tiffany L Kent .
The authorized official title is Owner, Physician and has the following contact phone number (616) 888-2948.

The enumeration date for this NPI number is 6/28/2016 and was last updated on 10/5/2016.


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
1207WX0200XOphthalmologyOphthalmic Plastic and Reconstructive Surgery4301092933MICHIGANYes

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
11164686812OTHERNPI

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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