Provider Demographics
NPI:1043256449
Name:KAISER, JAMES E (CERTIFIED OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:KAISER
Suffix:
Gender:M
Credentials:CERTIFIED OPTICIAN
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:210 N 6TH ST
Mailing Address - Street 2:PO BOX 64
Mailing Address - City:HARRISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48740-9686
Mailing Address - Country:US
Mailing Address - Phone:989-724-5136
Mailing Address - Fax:
Practice Address - Street 1:2483 US 23 S
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-4654
Practice Address - Country:US
Practice Address - Phone:989-356-6423
Practice Address - Fax:989-358-1953
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI382362609OtherTAX ID NUMBER