Provider Demographics
NPI:1083663090
Name:STILES EYECARE EXCELLENCE & GLAUCOMA INSTITUTE PA
Entity Type:Organization
Organization Name:STILES EYECARE EXCELLENCE & GLAUCOMA INSTITUTE PA
Other - Org Name:STILES EYECARE EXCELLENCE & GLAUCOMA INSTITUTE PA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-897-9299
Mailing Address - Street 1:7200 W 129TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2624
Mailing Address - Country:US
Mailing Address - Phone:913-897-9299
Mailing Address - Fax:913-897-3031
Practice Address - Street 1:7200 W 129TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2624
Practice Address - Country:US
Practice Address - Phone:913-897-9299
Practice Address - Fax:913-897-3031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004674580001Medicaid
MOL840000Medicare ID - Type Unspecified