Provider Demographics
NPI:1740415629
Name:DOYLESTOWN FAMILY EYE ASSOCIATES
Entity Type:Organization
Organization Name:DOYLESTOWN FAMILY EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:215-850-8552
Mailing Address - Street 1:16 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4217
Mailing Address - Country:US
Mailing Address - Phone:215-345-4186
Mailing Address - Fax:215-345-4196
Practice Address - Street 1:16 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4217
Practice Address - Country:US
Practice Address - Phone:215-345-4186
Practice Address - Fax:215-345-4196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001113152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA20697486OtherGREAT WEST
PA2271168000OtherINDEPENDENCE BLUE CROSS PERSONAL
PA1593439OtherHIGHMARK BLUE SHIELD
PA2367314OtherUNITED
PA1593439OtherHIGHMARK BLUE SHIELD FEP
PA2271168000OtherKEYSTONE
PA7314560OtherAETNA
PA2367314OtherUNITED
PA2271168000OtherKEYSTONE