Provider Demographics
NPI:1750472973
Name:MCPHERSON EYE CARE LLP
Entity Type:Organization
Organization Name:MCPHERSON EYE CARE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:ODLE
Authorized Official - Last Name:GOERING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:620-241-2262
Mailing Address - Street 1:PO BOX 1314
Mailing Address - Street 2:
Mailing Address - City:MCPHERSON
Mailing Address - State:KS
Mailing Address - Zip Code:67460
Mailing Address - Country:US
Mailing Address - Phone:620-241-2262
Mailing Address - Fax:620-241-2010
Practice Address - Street 1:1323 EAST FIRST
Practice Address - Street 2:
Practice Address - City:MCPHERSON
Practice Address - State:KS
Practice Address - Zip Code:67460
Practice Address - Country:US
Practice Address - Phone:620-241-2262
Practice Address - Fax:620-241-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100425600AMedicaid
1002240001Medicare NSC
043397Medicare PIN