Provider Demographics
NPI:1902196611
Name:PHYSICIANS EYE CLINIC,PLLC
Entity Type:Organization
Organization Name:PHYSICIANS EYE CLINIC,PLLC
Other - Org Name:PHYSICIANS EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-225-2566
Mailing Address - Street 1:2101 WESTOWN PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1542
Mailing Address - Country:US
Mailing Address - Phone:515-225-2566
Mailing Address - Fax:515-225-2425
Practice Address - Street 1:2101 WESTOWN PKWY
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-1542
Practice Address - Country:US
Practice Address - Phone:515-225-2566
Practice Address - Fax:515-225-2425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty