Provider Demographics
NPI:1528377769
Name:JOHN A FINN OD PC
Entity Type:Organization
Organization Name:JOHN A FINN OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FINN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:989-386-3401
Mailing Address - Street 1:110 W WHEATON AVE
Mailing Address - Street 2:
Mailing Address - City:CLARE
Mailing Address - State:MI
Mailing Address - Zip Code:48617-1247
Mailing Address - Country:US
Mailing Address - Phone:989-386-3401
Mailing Address - Fax:989-386-3225
Practice Address - Street 1:110 W WHEATON AVE
Practice Address - Street 2:
Practice Address - City:CLARE
Practice Address - State:MI
Practice Address - Zip Code:48617-1247
Practice Address - Country:US
Practice Address - Phone:989-386-3401
Practice Address - Fax:989-386-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002692332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2991827Medicaid
MI0A86505OtherMEDICARE ID
MI900A86505OtherBCBS OF MICHIGAN
MI410046607Medicare PIN
MIU29924Medicare UPIN
MI2991827Medicaid