Provider Demographics
NPI:1639369135
Name:CENTRAL POINT EYECARE, P.C.
Entity Type:Organization
Organization Name:CENTRAL POINT EYECARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:541-664-5535
Mailing Address - Street 1:650 E PINE ST
Mailing Address - Street 2:STE 105
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2400
Mailing Address - Country:US
Mailing Address - Phone:541-664-5535
Mailing Address - Fax:541-664-7745
Practice Address - Street 1:650 E PINE ST
Practice Address - Street 2:STE 105
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2400
Practice Address - Country:US
Practice Address - Phone:541-664-5535
Practice Address - Fax:541-664-7745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2302ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR274748Medicaid
OR807295000OtherBLUE CROSS
OR410047151OtherRAILROAD MEDICARE
OR807295000OtherBLUE CROSS
ORR111768Medicare PIN