Provider Demographics
NPI:1114561727
Name:OGEMAW EYE INSTITUTE PC
Entity Type:Organization
Organization Name:OGEMAW EYE INSTITUTE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELENAK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:989-345-8113
Mailing Address - Street 1:559 PROGRESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9399
Mailing Address - Country:US
Mailing Address - Phone:989-345-8113
Mailing Address - Fax:989-345-3687
Practice Address - Street 1:559 PROGRESS ST STE E
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9399
Practice Address - Country:US
Practice Address - Phone:989-345-8113
Practice Address - Fax:989-345-3687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty