Provider Demographics
NPI:1760686745
Name:EYECARE ASSOCIATES
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES
Other - Org Name:EYECARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-658-2456
Mailing Address - Street 1:1063 S STATE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-1900
Mailing Address - Country:US
Mailing Address - Phone:810-658-2456
Mailing Address - Fax:810-658-5307
Practice Address - Street 1:1063 S STATE RD STE 3
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1900
Practice Address - Country:US
Practice Address - Phone:810-658-2456
Practice Address - Fax:810-658-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI2540OtherEYEMED
MI0P31100OtherMEDICARE ADVANTAGE
MI0P31100OtherMEDICARE PLUS BLUE
MI0P31100OtherBCN ADVANTAGE
MI0P31100OtherBLUECARE NETWORK
MI0P31100OtherBCN ADVANTAGE
MI0842940001Medicare NSC