Provider Demographics
NPI:1164539748
Name:EYE CARE INC
Entity Type:Organization
Organization Name:EYE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIERY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-522-8311
Mailing Address - Street 1:P O BOX 366
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25708-0366
Mailing Address - Country:US
Mailing Address - Phone:304-522-8311
Mailing Address - Fax:304-522-8313
Practice Address - Street 1:1508 SIXTH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701
Practice Address - Country:US
Practice Address - Phone:304-522-8311
Practice Address - Fax:304-522-8313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004951Medicaid
001709509OtherMOUNTAIN STATE BLUE CROSS
0202460001Medicare NSC
001709509OtherMOUNTAIN STATE BLUE CROSS