Provider Demographics
NPI:1598447179
Name:REPKING EYE CARE PLLC
Entity Type:Organization
Organization Name:REPKING EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:REPKING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-663-0419
Mailing Address - Street 1:1000 KATRINA DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-0018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TEUTOPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62467-1340
Practice Address - Country:US
Practice Address - Phone:217-903-4117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty