Provider Demographics
NPI:1568634798
Name:CARMAN OPTOMETRY, P.C.
Entity Type:Organization
Organization Name:CARMAN OPTOMETRY, P.C.
Other - Org Name:VISIONARY EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-940-6200
Mailing Address - Street 1:6100 W 41ST ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-5556
Mailing Address - Country:US
Mailing Address - Phone:605-940-6200
Mailing Address - Fax:605-361-2705
Practice Address - Street 1:6100 W 41ST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-5556
Practice Address - Country:US
Practice Address - Phone:605-940-6200
Practice Address - Fax:605-361-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD51-001-E-ST332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
U73168Medicare UPIN