Provider Demographics
NPI:1891810248
Name:TOSS OPTOMETRY INC
Entity Type:Organization
Organization Name:TOSS OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:P
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:906-226-2020
Mailing Address - Street 1:131 W WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855
Mailing Address - Country:US
Mailing Address - Phone:906-226-2020
Mailing Address - Fax:906-226-4678
Practice Address - Street 1:131 W WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855
Practice Address - Country:US
Practice Address - Phone:906-226-2020
Practice Address - Fax:906-226-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003170152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
P12110001OtherMEMBER MEDICAID # M
MI1891810248OtherMEDICARE TYPE: PROFESSIONAL OFFICE
MI2606169Medicaid
900E210570OtherBLUE CROSS BLUE SHEILD
MIP12110001OtherMEMBER MEDICARE
MI1891810248OtherMEDICARE TYPE: PROFESSIONAL OFFICE
900E210570OtherBLUE CROSS BLUE SHEILD