UNIVERSITY PHYSICIAN GROUP NPI 1558680330

NPI Information

NPI: 1558680330
Provider Name: UNIVERSITY PHYSICIAN GROUP
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
6071 W OUTER DR
SUITE M-106
DETROIT, MI
ZIP 48235
Phone: (313) 966-2024
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UNIVERSITY PHYSICIAN GROUP is an eyewear supplier in Detroit, MI. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. UNIVERSITY PHYSICIAN GROUP NPI is 1558680330. The provider is registered as an organization entity type.

The provider's business location address is:

6071 W OUTER DR
SUITE M-106
DETROIT, MI
ZIP 48235-624
Phone: (313) 966-2024
Fax: (313) 966-7418

The provider's authorized official is Jeffery P Kohlitz .
The authorized official title is Chief Financial Officer and has the following contact phone number (248) 581-5930.

The enumeration date for this NPI number is 5/19/2010 and was last updated on 12/8/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332H00000X	Eyewear Supplier		4301054761	MICHIGAN	Yes

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
1	5717980003	MEDICARE NSC	MICHIGAN
2	5717980003	OTHER	MICHIGAN	NGS

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: 11/14/2023

NPI Synchronization or Removal

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