Provider Demographics
NPI:1083912059
Name:LANSING OPHTHALMOLOGY, P.C.
Entity Type:Organization
Organization Name:LANSING OPHTHALMOLOGY, P.C.
Other - Org Name:LO EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-337-1899
Mailing Address - Street 1:1005 CHARLEVOIX DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-8186
Mailing Address - Country:US
Mailing Address - Phone:517-337-1668
Mailing Address - Fax:517-622-1205
Practice Address - Street 1:702 W LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8526
Practice Address - Country:US
Practice Address - Phone:517-332-6523
Practice Address - Fax:517-332-3365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty