Provider Demographics
NPI:1790829257
Name:HELISEK, JOSEPH (OD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:HELISEK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3353
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48333-3353
Mailing Address - Country:US
Mailing Address - Phone:248-762-2701
Mailing Address - Fax:
Practice Address - Street 1:3883 E GRAND RIVER AVE
Practice Address - Street 2:VISION CENTER AT MEIJER
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8564
Practice Address - Country:US
Practice Address - Phone:517-552-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4010152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist