Provider Demographics
NPI:1699769836
Name:LAYMAN, ROBERT C (OD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:LAYMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 SUMMERLYN LAKES DR
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-0047
Mailing Address - Country:US
Mailing Address - Phone:734-854-3937
Mailing Address - Fax:734-854-5868
Practice Address - Street 1:6650 SUMMERLYN LAKES DR
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-0047
Practice Address - Country:US
Practice Address - Phone:734-854-3937
Practice Address - Fax:734-854-5868
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002-2861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI341585498OtherAETNA
MI03157OtherPARAMOUNT
MI22-01112OtherUNITED HEALTH
MI941931252Medicaid
MI341585498OtherVISION SERVICE PLAN
MI900E865120OtherBLUE CROSS BLUE SHIELD
MIT33285Medicare UPIN
MIE86512001Medicare PIN
MI410024802Medicare ID - Type UnspecifiedRAILROAD MDCR
MI0E86512Medicare PIN
OHRO0743461Medicare PIN
MI341585498OtherVISION SERVICE PLAN
MI941931252Medicaid
OH0627710002Medicare NSC