Mid-State Eye Partners INC
Optometrist in Shelbyville, IL. Organization (NPI-2).
NPI number1487005484
StatusActive
Last updated in NPPESMar 3, 2017
Details
- NPI
- 1487005484
- Entity type
- Organization (NPI-2)
- Legal business name
- Mid-State Eye Partners INC
- Organization subpart
- No
- Enumeration date
- Jun 30, 2016
- Last updated
- Mar 3, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 046010631 | IL | Yes |
Practice location
102 N Heinlein DrShelbyville, IL 62565-9050
Phone 217-774-4422 · Fax 217-772-4722
Mailing address
90 Clubview PlDecatur, IL 62521-2515
Phone 217-772-4422
Authorized official
Bradley Stewart Grant
Optometrist
2177744422
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Other Optometrist providers in Shelbyville, IL
- Theodore E Bogart, O.D.NPI 1609950401
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- Caitlin Gaughan, ODNPI 1437757473
- Joseph T MarcinNPI 1669467189
All 5 Optometrist providers in Shelbyville · All 162 providers in Shelbyville
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