Provider Demographics
NPI:1316428725
Name:BELDING FAMILY EYECARE LLC
Entity type:Organization
Organization Name:BELDING FAMILY EYECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:F
Authorized Official - Last Name:SEES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:202-308-4796
Mailing Address - Street 1:936 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELDING
Mailing Address - State:MI
Mailing Address - Zip Code:48809-9244
Mailing Address - Country:US
Mailing Address - Phone:616-794-9088
Mailing Address - Fax:616-794-9084
Practice Address - Street 1:936 W STATE ST
Practice Address - Street 2:
Practice Address - City:BELDING
Practice Address - State:MI
Practice Address - Zip Code:48809-9244
Practice Address - Country:US
Practice Address - Phone:616-794-9088
Practice Address - Fax:616-794-9084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004807152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1235320680OtherOPTOMETRY
MI1235320680Medicaid
MI1184816365Medicaid
MI1184816365OtherOPTOMETRY