Provider Demographics
NPI:1760867253
Name:TYLER BAARS, O.D., P.C.
Entity Type:Organization
Organization Name:TYLER BAARS, O.D., P.C.
Other - Org Name:BAARS EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAARS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:812-929-2848
Mailing Address - Street 1:1750 ROBERT ST S
Mailing Address - Street 2:
Mailing Address - City:WEST ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3919
Mailing Address - Country:US
Mailing Address - Phone:651-306-0412
Mailing Address - Fax:651-306-0414
Practice Address - Street 1:1750 ROBERT ST S
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3919
Practice Address - Country:US
Practice Address - Phone:651-306-0412
Practice Address - Fax:651-306-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-24
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3432152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400101426Medicare UPIN