Provider Demographics
NPI:1326208323
Name:CHILDREN'S EYE CARE, PC
Entity Type:Organization
Organization Name:CHILDREN'S EYE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-254-8140
Mailing Address - Street 1:6689 ORCHARD LAKE ROAD
Mailing Address - Street 2:#297
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322
Mailing Address - Country:US
Mailing Address - Phone:248-254-8140
Mailing Address - Fax:248-254-8150
Practice Address - Street 1:42700 GARFIELD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-4201
Practice Address - Country:US
Practice Address - Phone:586-532-3380
Practice Address - Fax:586-416-1608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
180E012390OtherBS
180E012390OtherBS