Provider Demographics
NPI:1295861474
Name:EUGENE BARON, O.D., P.C.
Entity Type:Organization
Organization Name:EUGENE BARON, O.D., P.C.
Other - Org Name:PATRICK LYONS, O.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-548-6888
Mailing Address - Street 1:817 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1837
Mailing Address - Country:US
Mailing Address - Phone:248-548-6888
Mailing Address - Fax:248-548-6889
Practice Address - Street 1:817 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1837
Practice Address - Country:US
Practice Address - Phone:248-548-6888
Practice Address - Fax:248-548-6889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002816152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110787OtherEYEMED
MI=========OtherVSP