Provider Demographics
NPI:1841425899
Name:CLARIS EYE CARE & SURGERY, P.A.
Entity Type:Organization
Organization Name:CLARIS EYE CARE & SURGERY, P.A.
Other - Org Name:CLARIS EYE CARE & SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-775-8009
Mailing Address - Street 1:710 E 24TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3810
Mailing Address - Country:US
Mailing Address - Phone:612-775-8009
Mailing Address - Fax:612-775-8005
Practice Address - Street 1:710 E 24TH ST STE 102
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3810
Practice Address - Country:US
Practice Address - Phone:612-775-8009
Practice Address - Fax:612-775-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28116207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty