Provider Demographics
NPI:1225015597
Name:OPHTHALMOLOGY PC
Entity Type:Organization
Organization Name:OPHTHALMOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PECHOUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-588-4675
Mailing Address - Street 1:300 N GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6397
Mailing Address - Country:US
Mailing Address - Phone:563-588-4675
Mailing Address - Fax:563-588-1195
Practice Address - Street 1:300 N GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6397
Practice Address - Country:US
Practice Address - Phone:563-588-4675
Practice Address - Fax:563-588-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty