Provider Demographics
NPI:1427895234
Name:NSB EYE INC
Entity type:Organization
Organization Name:NSB EYE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:REED
Authorized Official - Last Name:WILGERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:386-747-2867
Mailing Address - Street 1:406 PALMETTO ST STE A
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA
Mailing Address - State:FL
Mailing Address - Zip Code:32168-7323
Mailing Address - Country:US
Mailing Address - Phone:386-747-2867
Mailing Address - Fax:
Practice Address - Street 1:406 PALMETTO ST STE A
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-7323
Practice Address - Country:US
Practice Address - Phone:386-747-2867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty