Provider Demographics
NPI:1962577783
Name:THE EYE GUYS, INC.
Entity type:Organization
Organization Name:THE EYE GUYS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:412-922-2305
Mailing Address - Street 1:232 CRAFTON INGRAM SHOPPING CENTER
Mailing Address - Street 2:
Mailing Address - City:CRAFTON
Mailing Address - State:PA
Mailing Address - Zip Code:15205-2353
Mailing Address - Country:US
Mailing Address - Phone:412-922-2305
Mailing Address - Fax:412-922-0688
Practice Address - Street 1:232 CRAFTON INGRAM SHOPPING CENTER
Practice Address - Street 2:
Practice Address - City:CRAFTON
Practice Address - State:PA
Practice Address - Zip Code:15205-2353
Practice Address - Country:US
Practice Address - Phone:412-922-2305
Practice Address - Fax:412-922-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET-009060152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAEY1821119OtherBLUE CROSS
PA099922U88Medicare ID - Type Unspecified
PAU51072Medicare UPIN