Provider Demographics
NPI:1346343878
Name:ROBERT JAY ZENDLER II DO PC
Entity Type:Organization
Organization Name:ROBERT JAY ZENDLER II DO PC
Other - Org Name:VALLEY EYE CONSULTANTS PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-733-5535
Mailing Address - Street 1:4281 LENNON RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1024
Mailing Address - Country:US
Mailing Address - Phone:810-733-5535
Mailing Address - Fax:810-733-1076
Practice Address - Street 1:4281 LENNON RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507
Practice Address - Country:US
Practice Address - Phone:810-733-5535
Practice Address - Fax:810-733-1076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101009018207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1852509745OtherBLUE CROSS BLUE SHIELD
MI1992122OtherMOLINA HEALTH CARE
MI1992122Medicaid
MI144297OtherSELECTCARE
4087251OtherAETNA
MI5250974502OtherHEALTH PLUS
MIC2207OtherM-CARE
MI5250974OtherMEDICARE PLUS BLUE
MICE1334OtherMEDICARE RAILROAD
MIP60055OtherBLUE CARE NETWORK
180007000OtherMEDICARE RAILROAD
MI202136OtherMCLAREN HEALTH PLAN
MI105249OtherCARE CHOICES
MI202136OtherHEALTH ADVANTAGE
205340OtherCOLE MANAGED VISION
MIF07167OtherHEALTH ALLIANCE PLAN
F07167Medicare UPIN
MI1992122Medicaid
MI202136OtherHEALTH ADVANTAGE
MI5250974OtherMEDICARE PLUS BLUE