Provider Demographics
NPI:1790744639
Name:FIGGS EYE CLINIC, P.C.
Entity Type:Organization
Organization Name:FIGGS EYE CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:509-453-2010
Mailing Address - Street 1:1410 LAKESIDE CT STE 103
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7305
Mailing Address - Country:US
Mailing Address - Phone:509-453-2010
Mailing Address - Fax:509-225-6421
Practice Address - Street 1:1410 LAKESIDE CT STE 103
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7305
Practice Address - Country:US
Practice Address - Phone:509-453-2010
Practice Address - Fax:509-225-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003392152W00000X
WAOP00000819207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1498203Medicaid
WA0144129OtherLABOR AND INDUSTRY
WA1498203Medicaid
WAE20247Medicare UPIN
WA0263330001Medicare NSC