Provider Demographics
NPI:1417157751
Name:DR. CURTIS EYECARE, PC
Entity Type:Organization
Organization Name:DR. CURTIS EYECARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-878-3600
Mailing Address - Street 1:2155 84TH ST SW
Mailing Address - Street 2:
Mailing Address - City:BYRON CENTER
Mailing Address - State:MI
Mailing Address - Zip Code:49315-8260
Mailing Address - Country:US
Mailing Address - Phone:616-878-3600
Mailing Address - Fax:616-878-7098
Practice Address - Street 1:2155 84TH ST SW
Practice Address - Street 2:
Practice Address - City:BYRON CENTER
Practice Address - State:MI
Practice Address - Zip Code:49315-8260
Practice Address - Country:US
Practice Address - Phone:616-878-3600
Practice Address - Fax:616-878-7098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002997152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N84790Medicare PIN
MI1092150001Medicare NSC