Provider Demographics
NPI:1114066644
Name:BAY OPTICAL COMPANY
Entity Type:Organization
Organization Name:BAY OPTICAL COMPANY
Other - Org Name:DAVID R TAYLOR OWNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-686-6400
Mailing Address - Street 1:106 N ERIE ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-4402
Mailing Address - Country:US
Mailing Address - Phone:989-686-6400
Mailing Address - Fax:989-686-5600
Practice Address - Street 1:106 N ERIE ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-4402
Practice Address - Country:US
Practice Address - Phone:989-686-6400
Practice Address - Fax:989-686-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0200000001Medicare ID - Type Unspecified