Provider Demographics
NPI:1659393635
Name:PHYSICIANS EYE CLINIC, PLLC
Entity Type:Organization
Organization Name:PHYSICIANS EYE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:425-551-5204
Mailing Address - Street 1:3930 HOYT AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4919
Mailing Address - Country:US
Mailing Address - Phone:425-259-2020
Mailing Address - Fax:425-259-2801
Practice Address - Street 1:3930 HOYT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4919
Practice Address - Country:US
Practice Address - Phone:425-259-2020
Practice Address - Fax:425-259-2801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty