Provider Demographics
NPI:1063459931
Name:EYE PHYSICIANS PC
Entity Type:Organization
Organization Name:EYE PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:856-784-3366
Mailing Address - Street 1:1140 WHITE HORSE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2106
Mailing Address - Country:US
Mailing Address - Phone:856-784-3366
Mailing Address - Fax:856-784-4388
Practice Address - Street 1:1140 WHITE HORSE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2106
Practice Address - Country:US
Practice Address - Phone:856-784-3366
Practice Address - Fax:856-784-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2703106Medicaid
NJ2703106Medicaid
PA076819Medicare PIN