Provider Demographics
NPI:1598147100
Name:HOINS, STACEY LEIGH (OD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:LEIGH
Last Name:HOINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 E BARNETT RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8219
Mailing Address - Country:US
Mailing Address - Phone:541-779-4711
Mailing Address - Fax:541-618-1485
Practice Address - Street 1:1333 E BARNETT RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8219
Practice Address - Country:US
Practice Address - Phone:541-779-4711
Practice Address - Fax:541-618-1485
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3612ATI152W00000X, 152WL0500X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation