Provider Demographics
NPI:1891113163
Name:DR. TOM SCZEPANSKI EYE CARE, LLC
Entity Type:Organization
Organization Name:DR. TOM SCZEPANSKI EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCZEPANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:507-398-3802
Mailing Address - Street 1:3675 NOTTINGHAM DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3197
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 55TH ST NW
Practice Address - Street 2:WALMART NORTH
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0123
Practice Address - Country:US
Practice Address - Phone:507-280-8438
Practice Address - Fax:507-280-9284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-02
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2418152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty