Provider Demographics
NPI:1053490979
Name:MATTHEW J. EMERY, OD, P.C.
Entity Type:Organization
Organization Name:MATTHEW J. EMERY, OD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:EMERY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:616-754-5427
Mailing Address - Street 1:4065 WHIRLWIND DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8291
Mailing Address - Country:US
Mailing Address - Phone:616-754-5427
Mailing Address - Fax:616-754-5428
Practice Address - Street 1:10772 W CARSON CITY RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-9141
Practice Address - Country:US
Practice Address - Phone:616-754-5427
Practice Address - Fax:616-754-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004005152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty