Provider Demographics
NPI:1992991426
Name:HADDEN EYECARE ASSOCIATES
Entity type:Organization
Organization Name:HADDEN EYECARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:HADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:952-443-3110
Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:MN
Mailing Address - Zip Code:55386-0300
Mailing Address - Country:US
Mailing Address - Phone:952-443-3110
Mailing Address - Fax:952-443-2387
Practice Address - Street 1:715 E 78TH ST
Practice Address - Street 2:C/O WAL-MART VISION CENTER
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-1397
Practice Address - Country:US
Practice Address - Phone:952-854-2262
Practice Address - Fax:952-854-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2243152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty