Provider Demographics
NPI:1235168915
Name:BAY EYE CARE CENTER, PC
Entity Type:Organization
Organization Name:BAY EYE CARE CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:STESLICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-892-9595
Mailing Address - Street 1:116 N TUSCOLA RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6961
Mailing Address - Country:US
Mailing Address - Phone:989-892-9595
Mailing Address - Fax:989-892-3080
Practice Address - Street 1:116 N TUSCOLA RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6961
Practice Address - Country:US
Practice Address - Phone:989-892-9595
Practice Address - Fax:989-892-3080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0206630001Medicare NSC
0Z96211Medicare ID - Type Unspecified