Provider Demographics
NPI:1740431360
Name:LORRAINE BYERS-MILLER O.D., P.C.
Entity Type:Organization
Organization Name:LORRAINE BYERS-MILLER O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BYERS-MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:810-845-3628
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:MI
Mailing Address - Zip Code:48457-0156
Mailing Address - Country:US
Mailing Address - Phone:810-845-3628
Mailing Address - Fax:
Practice Address - Street 1:11493 NORTH LINDEN RD
Practice Address - Street 2:
Practice Address - City:CLIO
Practice Address - State:MI
Practice Address - Zip Code:48420
Practice Address - Country:US
Practice Address - Phone:810-564-9264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004311152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
90-0-B5-14570OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
0P63100Medicare PIN