Provider Demographics
NPI:1033124268
Name:MICHELE & RICHARD JAMISON, M.D.'S, P.C.
Entity Type:Organization
Organization Name:MICHELE & RICHARD JAMISON, M.D.'S, P.C.
Other - Org Name:JAMISON EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAMISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-225-5883
Mailing Address - Street 1:90 ERIE CANAL DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4601
Mailing Address - Country:US
Mailing Address - Phone:585-225-5883
Mailing Address - Fax:585-225-8902
Practice Address - Street 1:90 ERIE CANAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4601
Practice Address - Country:US
Practice Address - Phone:585-225-5883
Practice Address - Fax:585-225-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201772207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTRICARE
NY=========OtherTRICARE
NY1263220001Medicare NSC