Michiana Eye Center Llc in South Bend - Plastic Surgery Within The Head And Neck
Michiana Eye Center Llc - NPI 1073671731
Michiana Eye Center Llc is a Plastic Surgery Within The Head And Neck in South Bend, Indiana. Michiana Eye Center Llc practices all healthcare services and medical treatments related to Plastic Surgery Within The Head And Neck. The NPI Number for Michiana Eye Center Llc is 1073671731. The last update date is 2018-06-18.
Michiana Eye Center Llc's current location address is 319 N Niles Ave # 100, South Bend, Indiana. You can contact this provider via phone number 5742822020 and fax number 5742882020. The mailing address for Michiana Eye Center Llc is 319 N Niles Ave # 100, South Bend, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Michiana Eye Center Llc |
|---|---|
| Address | 319 N Niles Ave # 100, South Bend, Indiana |
| Phone Number | 5742822020 |
| Fax Number | 5742882020 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/OPHT |
|---|---|
| Authorized Official Name | Baxter R Kevin |
| Credentials | DO |
| Telephone Number | 5742713939 |
NPI Number Detail
| NPI Number | 1073671731 |
|---|---|
| Provider Enumeration Date | 2006-12-05 |
| Last Updated Date | 2018-06-18 |
Provider Mailing Address Detail
| Address | 319 N Niles Ave # 100 |
|---|---|
| City | South Bend |
| State | Indiana (IN) |
| Post Code | 46617 |
| Phone Number | 5742822020 |
| Fax Number | 5742882020 |
Provider's Primary Taxonomy Detail
| Speciality | Plastic Surgery Within The Head And Neck |
|---|---|
| Taxonomy | 2082S0099X |
|
Definition: A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 204460 | IN | MEDICARE PTAN | |
| 100092980 | IN | -- | |
| DA1131 | IN | RAILROAD MEDICARE |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Michiana Eye Center Llc by the Centers for Medicare & Medicaid Services?
The Michiana Eye Center Llc has been assigned the NPI (National Provider Identifier) 1073671731 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Michiana Eye Center Llc is located?
The Michiana Eye Center Llc is situated at the following address: 319 N Niles Ave # 100, South Bend, IN, 46617.
What is Michiana Eye Center Llc's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Michiana Eye Center Llc is Plastic Surgery Within The Head And Neck, and the taxonomy code that classifies this field of practice is 2082S0099X.
On what date did the Michiana Eye Center Llc receive the assignment of its 1073671731 from the Centers for Medicare & Medicaid Services?
The Michiana Eye Center Llc was issued its 1073671731 by the Centers for Medicare & Medicaid Services on 2006-12-05.
When was the information regarding Michiana Eye Center Llc most recently updated?
The details pertaining to the Michiana Eye Center Llc, including its address, specialty, and other relevant information, were last refreshed on 2018-06-18.