Provider Demographics
NPI:1487809810
Name:ALL EYES,PC
Entity type:Organization
Organization Name:ALL EYES,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:REED,JR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:269-983-3200
Mailing Address - Street 1:2047 NILES RD
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MI
Mailing Address - Zip Code:49085-2505
Mailing Address - Country:US
Mailing Address - Phone:269-983-3200
Mailing Address - Fax:269-983-4902
Practice Address - Street 1:2047 NILES RD
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-2505
Practice Address - Country:US
Practice Address - Phone:269-983-3200
Practice Address - Fax:269-983-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002725152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6121460001Medicare NSC
MI0P62220Medicare PIN