Provider Demographics
NPI:1366470957
Name:PRECISION EYE CARE, INC.
Entity Type:Organization
Organization Name:PRECISION EYE CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FITZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:573-756-2020
Mailing Address - Street 1:140 WESTMOUNT DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2970
Mailing Address - Country:US
Mailing Address - Phone:573-756-2020
Mailing Address - Fax:573-756-6997
Practice Address - Street 1:140 WESTMOUNT DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-2970
Practice Address - Country:US
Practice Address - Phone:573-756-2020
Practice Address - Fax:573-756-6997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO500247002Medicaid
D08053Medicare UPIN
MO500247002Medicaid
MO990000982Medicare PIN