Provider Demographics
NPI:1346405891
Name:EYE PHYSICIANS GROUP LLC
Entity Type:Organization
Organization Name:EYE PHYSICIANS GROUP LLC
Other - Org Name:BAGAN STRINDEN VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-293-8242
Mailing Address - Street 1:4344 20TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-7436
Mailing Address - Country:US
Mailing Address - Phone:701-293-8242
Mailing Address - Fax:
Practice Address - Street 1:4344 20TH AVE SW
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-7436
Practice Address - Country:US
Practice Address - Phone:701-293-8242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty