EAGLE EYE SURGERY AND LASER CENTER LLC NPI 1235255605

NPI Information

EAGLE EYE SURGERY AND LASER CENTER LLC is an ambulatory surgical clinic center in Meridian, ID. EAGLE EYE SURGERY AND LASER CENTER LLC NPI is 1235255605. The provider is registered as an organization entity type.
The provider Is Doing Business As Eagle Eye Surgery & Laser Center.

The provider's business location address is:

3090 E GENTRY WAY STE 100
MERIDIAN, ID
ZIP 83642-548
Phone: (208) 288-1600
Fax: (208) 288-4299

The provider's authorized official is Phillip Clendenin .
The authorized official title is President and has the following contact phone number (615) 665-1283.

The CLIA number assigned to this NPI record is 13D0976451 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 12/2/2014.

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:

Other Identifiers

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