Provider Demographics
NPI:1902837453
Name:EYE PARTNERS PC
Entity Type:Organization
Organization Name:EYE PARTNERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARNIX
Authorized Official - Middle Name:E
Authorized Official - Last Name:HEERSINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-793-2211
Mailing Address - Street 1:2800 ROSS CLARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301
Mailing Address - Country:US
Mailing Address - Phone:334-793-2211
Mailing Address - Fax:334-793-7161
Practice Address - Street 1:2800 ROSS CLARK CIRCLE
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301
Practice Address - Country:US
Practice Address - Phone:334-793-2211
Practice Address - Fax:334-793-7161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529903390Medicaid
CG3904OtherRAILROAD MEDICARE GROUP
AL529903390Medicaid
ALH758Medicare ID - Type UnspecifiedGROUP NUMBER
FLK5420Medicare ID - Type UnspecifiedGROUP NUMBER